ESTRO Brachytherapy for Prostate Cancer 2018

Radiation proctitis - Chronic

Histological findings • obliterative endarteritis of the small vessels in the intestinal wall characterizes chronic radiation intestinal injury • Associated lymphoid atrophy, lymphatic dilation, and fibrosis of the submucosal tissue are observed • The progressive vascular sclerosis leads to chronic ischemia of the overlying tissue, ultimately resulting in mucosal atrophy • Scar tissue replaces the submucosal tissue, resulting in further decrease in vascularity and contracture of the intestinal wall • Chronic mucosal ulceration may result in fistula formation and hemorrhage