Bloed W, van Eijkeren M A, van Es C A, Borel Rinkes I H M
Afd. Heelkunde, Universitair Medisch Centrum, Postbus 85.500, 3508 GA Utrecht.
Ned Tijdschr Geneeskd. 2002 Nov 9;146(45):2117-20.
Three women aged 74, 59 and 36 years, had chronic complaints of abdominal pain, nausea, vomiting and diarrhoea, 1 to 8 years after radiotherapy for pelvic malignancies. Mechanical ileus due to fibrotic adhesions was found to be the cause; all three patients recovered after one or more operations. The prevalence of chronic radiation injury correlates with both radiation factors (volume) and patient characteristics. If possible, tumour recurrence needs to be excluded. Chronic intermittent ileus is the predominant symptom of chronic radiation injury. It often occurs within 2 years, but sometimes as long as 10 to 20 years after radiotherapy. Resection is warranted when short segments are affected. In other cases an intestinal bypass or stoma is the treatment of choice.
三名年龄分别为74岁、59岁和36岁的女性，在盆腔恶性肿瘤放疗后1至8年，长期存在腹痛、恶心、呕吐和腹泻的症状。发现病因是纤维化粘连导致的机械性肠梗阻；所有三名患者在接受一次或多次手术后康复。慢性放射损伤的发生率与放射因素（剂量）和患者特征均相关。如有可能，需要排除肿瘤复发。慢性间歇性肠梗阻是慢性放射损伤的主要症状。它通常在放疗后2年内出现，但有时长达10至20年。当短节段受累时，有必要进行切除。在其他情况下，肠道旁路手术或造口术是首选治疗方法。
