Necrotizing Fasciitis of the Thigh Secondary to Radiation Colitis in a Rectal Cancer Patient

Necrotizing fasciitis usually occurs after dermal injury or through hematogenous spread. To date, few cases have been reported as necrotizing fasciitis of the thigh secondary to rectal perforation in rectal cancer patients. A 66-year-old male complained of pelvic and thigh pain and subsequently developed necrotizing fasciitis in his right thigh. Four years earlier, he had undergone a low anterior resection and radiotherapy due to of rectal cancer. An ulcerative lesion had been observed around the anastomosis site during the colonoscopy that had been performed two months earlier. Pelvic computed tomography and sigmoidoscopy showed rectal perforation and presacral abscess extending to buttock and the right posterior thigh fascia. Thus, the necrotizing fasciitis was believed to have occurred because of ulcer perforation, one of the complications of chronic radiation colitis, at the anastomosis site. When a rectal-cancer patient complains of pelvic and thigh pain, the possibility of a rectal perforation should be considered.

A Case of Rectal Adenocarcinoma with Radiation Colitis / 대한소화기내시경학회지

Radiotherapy induced colorectal adenocarcinoma with radiation colitis after radiotherapy has been reported as a rare case. A patient with rectal adenocarcinoma as a late complication of pelvic irradiation for gynecological malignancy is reported. A 55-year-old woman with bloody diarrhea for 6 months was admitted. She received radiation therapy for carcinoma of cervix 21 years ago. Colonoscopic findings revealed a polypoid mass on rectosigmoid colon. Histopathologic examination of the polypectomy specimen disclosed adenocarcinoma. We reported herein a case of rectal adenocarcinoma with radiation colitis. The patient who had received pelvic irradiation should have close follow-up with colonoscopic study for the early detection of colorectal cancer.

The effect of Total Dose of Radiation on Normal Colon of Hybird Mice / 대한치료방사선과학회지

Optimal balance between control probability and risk of complication is emphasized even in present time. Although certain incidence of intestinal injury is accepted as an inevitable consequence after abdominopelvic irradiation, these complications still remain as problems. 60 mice were irradiated with 250kVp orthovoltage x-ray machine and 200 rad x5/wk regimen. Histpathologic findings of colorectum and the relationship with occult blood test were analyzed and possible tolerable dose which would be safe from permanent complication was also estimated. Followings are the results: Mild mucosal and submucosal edema were observed in 1,000 rad irradiated group. Congestion of small vessels was prominent in 2,000 rad irradiated group and infiltration of inflammatory cells was observed in 3,000 rad irradiated group. Denuded mucosa was observed in 3,000 rad irradiated group. Occult blood test is not a proper indicator for rectal denuding or rectal ulcer, but our results suggest the possibility of using this as a relative scale of intestinal damage. Mitotic figures of crypt cells were observed even in 5,000 rad irradiated group, these suggest that the repair capacity of crypt cells are still functioning.