Small bowel radiation enteritis diagnosed by capsule endoscopy

Abstract

Our patient is a middle-aged woman who had been diagnosed with uterine leiomyosarcoma for which she underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy. She received adjuvant radiotherapy which was delivered over a period of 4 weeks and which involved 20 fractions of 225cGy each for a total of 4500cGy, followed by a further two courses of pelvic radiotherapy in view of local recurrence. She presented to us with severe transfusion-dependent anaemia associated with loose stools and abdominal pain 1 year after initial surgery. Abdominal CT and oesophagogastroduodenoscopy were normal and a colonoscopy revealed large stains with fresh blood and small clots on normal mucosa in the caecum and ascending colon. Since the impression was that the source of bleeding was from the small intestine the patient was thus scheduled to have video capsule endoscopy (VCE) after ensuring that there was no retention of the patency capsule.