C a s e reports prescription, radiotherapists can now minimize these problems.
Although no organic obstruction was demonstrable on contrast radiology, or at operation, an aperistaltic functionai obstruction was found in a fixed retroperitoneal portion of the small bowel, adjacent to the right renal bed. The obstructive symptoms were caused by dysfunction of the bowel wall due to the effects of radiotherapy, rather than by the (quiescent) peptic ulcer, and was relieved by bypass operation.
Duodenal obstruction following radiation for pelvic disease is a recognized complication, and colonic stenosis after radiotherapy for a kidney neoplasm has been reported3. In 1982 Linhard and Egger4 described two cases of duodenal stenosis due to irradiation of the right kidney after nephrectomy, and referred to four others. They suggested that the duodenum may fall into the renal area after nephrectomy.
In all of these cases there was physical obstruction of the lumen, whereas a functional obstruction implies absent or ineffective peristalsis. This appears to be the first reported case of a functional complete duodenal obstruction following radiotherapy for adenocarcinoma of the right kidney.