Radiation damage to the rectum

Radiation damage can occur when radiation therapy (see) tumors of the rectum cancer and related bodies, mainly cervical cancer. Due to the improvement in the technique of exposure and use of contrast x-ray method to determine the localization of abdominal organs of radiation damage to the rectum in recent years are rare.
The most common form of these injuries - subacute leaking radiation recta. The first symptoms are identified by the end of radiation therapy and expressed tenesmus, a sense of pressure and pain before defecation; chair becomes frequent, in stool appear mucus and blood.
With relatively minor injuries when rectoscopy find uniform (with radiation therapy of tumors of the rectum) or limited front wall of the colon (radiation therapy of cancer of the cervix) hyperemia and edema of the mucous membrane, and later develops radioepitheliitis (see). Epithelization of the mucous membrane and the disappearance of clinical symptoms occur in the coming weeks.
Radiation therapy for cancer of the rectum mild form of rechica are not a contraindication for continuing radiation therapy. Ranjit radiation therapy of cancer of the cervix requires interruption of treatment.
A more severe form of radiation injury rectal ulcer Ranjit long, often progressing, frequent exacerbations process. There is frequent in patients chair with blood and mucus, alternating with constipation, painful tenesmus, debilitating patients; sharp cramping pain before, during and after defecation and dragging pain at rest; frequent rectal bleeding. Patients lose the weight, often fever.
When rectoscopy find hyperemia and edema of the mucous membrane, the phenomenon of radioepitheliitis and on the place of the greatest radiation exposure - ulceration. Radiation therapy for cancer of the cervix ulcer is located on the front wall of the colon at the level of the throat of the cervix; surrounding the ulcer infiltrate involves the back wall of the vagina. On the ground ulcer in these cases often arise recto-vaginal fistula.
Ulcerative Ranjit in some cases, radiation therapy for cancer of the cervix is accompanied by extensive sclerosis and lymphostasis pararectal cellular tissue due to impaired blood and lymph circulation. Rectum thus loses mobility, thickens. Infiltrated the pararectal cellular tissue captures the rectum. Dense or testolini consistency infiltration, with a smooth surface squeezes the rectum, reducing its clearance. On the front wall of the intestine ulcer occurs. The edges of the ulcer dense, rise above the level of the mucous membrane, the bottom is covered necrotic bloom, in the slightest trauma bleeding. The study is extremely painful.
This form of ulcerative rechica called pseudorandom, because the clinical picture is somewhat reminiscent of inoperable cancer of the rectum.
The healing of ulcerative rechica long, often accompanied partial or complete obstruction of the rectum, sometimes requiring stoma.
Treatment: systematic arasakmarisia procaine blockade (0.25% solution novokaina - 150 ml penicillin, 100 000-200 000 IU; 5% solution of vitamin B1 2 ml) and enema - oil or peloidinum; enemas from the extract of a camomile, as well as of 30% solution chloromycetinbuy paste.