# Multidisciplinary Surgical Management of Radiation-Induced Colorectal Stricture and Pelvic Adhesions: A Case Report

## TL;DR

A complex case of radiation-induced colorectal stricture and pelvic adhesions was managed through multidisciplinary surgery and coordinated medical care.

## Contribution

This case report presents a comprehensive surgical approach to a rare and complex radiation complication.

## Key findings

- A single-stage multidisciplinary surgical reconstruction was performed for a patient with multiple radiation-induced complications.
- Postoperative complications were managed through coordinated medical interventions including electrolyte repletion and nutritional support.
- The case highlights the importance of collaboration among surgical and medical teams in managing late radiation effects.

## Abstract

Radiation-induced colorectal strictures represent a challenging late complication of pelvic malignancy treatment, often accompanied by extensive fibrosis and multi-organ involvement. We report the case of a 55-year-old female with a history of cervical cancer treated with pelvic radiation, complicated by radiation proctitis, diverticular disease, pelvic adhesions, and bilateral ureteral obstruction, who underwent a single-stage multidisciplinary surgical reconstruction. The procedure included colostomy takedown, rectosigmoid resection with coloanal anastomosis, pelvic abscess debridement, diverting loop ileostomy creation, total abdominal hysterectomy, ileoureteral conduit formation, and ventral hernia repair with myocutaneous flap closure. The postoperative course was complicated by a high-output ileostomy resulting in electrolyte derangements, acute kidney injury, and malnutrition, requiring coordinated medical management with antidiarrheal therapy, electrolyte repletion, and nutritional support. This case underscores the complexity of late radiation sequelae and highlights the importance of multidisciplinary collaboration in achieving successful surgical and medical outcomes.