Small bowel edema after rectal cancer radiotherapy

Case contributed by Vikas Shah
Diagnosis probable

Presentation

Initial imaging showed a 3 cm circumferential cancer of mid rectum, staged as T3 N1 M0. Underwent chemoradiotherapy. Restaging MRI.

Patient Data

Age: 60 years
Gender: Female

Compared to the original MRI, there is an excellent response to therapy with a marked reduction in bulk and signal of the lesion. A very small volume of intermediate signal tissue remains at the most distal aspect of the tumor which may represent a small volume of residual tumor tissue. The lymphadenopathy has also responded. There is edema of pelvic small bowel indicating radiation enteritis.

No focal suspicious liver lesion.

Case Discussion

There were no specific symptoms or signs attributable to the imaging findings of small bowel edema. The bowel loops lie low in the pelvis and the favored diagnosis was mild acute small bowel radiation enteritis.

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