Page 33 - Radiology Book

nb: radiated Pelvis
1. NEVER in ate the rectal balloon in a patient who has received pelvic radiation.
2. Pelvic radiation is usually seen in patients with cervical or prostate carcinoma.
3. Barium enemas are rarely performed during the acute phase ( rst week after radiotherapy). Findings would include spasm, edema, and granular mucosa.
4. Barium enema in chronic radiation damage reveals a smooth, featureless mucosa with absent valves of Houston and a narrowed lumen.
5. The etiology of radiation colitis is progressive destruction of colonic microvasculature.
Waiting periods before enema examination or CT colonography after endoscopic colonic biopsy:
Barium enema examination and CT colonography should be delayed for at least seven days after:
• Forceps biopsy of colon through rigid proctoscope or anoscope • Polypectomy (rigid or exible scope
• Any biopsy or polypectomy using electrocautery (“hot” forceps)
Same day barium enema examination and CT colonography are acceptable after colonoscopic biopsy of the surface of a colonic mass (carcinoma or large polyp) without electrocautery if the patient has no clinical signs of perforation.
At the radiologist’s discretion, although not routinely done, a barium enema examination or CT colonography may be performed on the same day as a biopsy of a at area of colonic mucosa performed with colonoscopic biopsy forceps without electrocautery. Use caution in making this decision as occasional “super cial” biopsies of this type do extend into the muscularis propria and therefore confer some risk.
radiology notes
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GI Protocol