Radiation colitis refers to injury-inflammation to the colon caused by radiation therapy. It is usually associated with treatment for prostate cancer or cervical cancer. It can be part of the spectrum of radiation enteritis (which can occur together). Radiation colitis may develop 6 months to 5 years after regional radiotherapy 1. Onset can be acute or chronic.
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Radiographic features
CT
Acute radiation colitis can often manifest as spasm, mucosal irregularity, or nodular submucosal thickening. An increase in the presacral space and thickening or effacement of the valves of Houston and interhaustral folds can be seen.
Chronic radiation colitis can often manifest as strictures (may be long or short) and generally have tapered margins. Ulceration, fistulation and sinus tracts can also sometimes develop.
Differential diagnosis
Imaging differential considerations include:
- other colitises
- ulcerative colitis
- Crohn colitis
- infective colitis: pseudomembranous, amebiasis, schistosomiasis
- ischemic colitis
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