Small bowel perforation after radiotherapy for cervical carcinoma.
Radiotherapy is the treatment of choice for carcinoma of the uterine cervix. We report on a 62-year-old Chinese woman with cervical carcinoma, in whom a small bowel perforation developed 5 months after radiotherapy. Ten centimetres of small bowel, including the perforation site, were resected. No bowel adhesion was detected during the operation. The postoperative course was uneventful, and the patient was discharged home 7 days after surgery. Histological examination confirmed post-irradiation injury. The presenting complaints of patients with bowel perforation following radiotherapy vary, and signs of peritonitis may be absent. Emergency physicians must be alert for these complications in patients who have been treated with radiotherapy.
Budd-Chiari syndrome (BCS) with an intracaval stent is a rare presentation. In most Western patients with BCS, it is predominantly the hepatic veins that are involved, not the inferior vena cava (IVC). In the case presented, the patient had antiphospholipid syndrome with BCS that involved the IVC and required an intracaval stent. Presented with the case study are scanning techniques for BCS and the IVC to help sonographers evaluate the normal and abnormal anatomy and hemodynamics of this system.