Chronic radiation colitis - Example 3
This 63-year-old white female had been diagnosed two years previously with anal carcinoma and underwent radiation and chemotherapy. Cicatricial changes of the anal canal were excised one year ago.
The current colonoscopy was ordered as part of the work-up of chronic iron deficiency anemia sufficiently severe to require transfusion. The patient herself reported only small amounts of bright red blood and some mucus.
Changes begin in the lower sigmoid colon and increase distally. The mucosa shows splotchy erythema with numerous areas of teleangiectasy. Immediately adjacent to the anal canal is a cavity lined with epithelium, possibly a remnant of the excision of scar tissue.
Colonoscopy was performed very carefully. The examination was reported to be more painful than usual. The changes are very typical and may develop years after radiation exposure. The rectal application of budesonide was recommended.