Radiography of the small bowel in patients with gynecologic malignancies

The records and radiographs of 284 patients with gynecologic malignancy were reviewed to determine the incidence and nature of small-bowel abnormalities. Seventeen percent of the patients had small-bowel studies. Twenty-four percent of patients with ovarian cancer had radiologic examination of the small bowel, and in almost all cases the abnormalities were due to metastatic disease. In patients with cervical cancer, small-bowel radiography was performed in 14% of patients, and in most cases the abnormalities were due to radiation damage. Small-bowel obstruction was found in 20 patients. In the ovarian-cancer group, all obstructions were due to metastatic disease, whereas in the cervical cancer group, obstruction was due to metastases, radiation, or adhesions. The site of obstruction was a useful differential point, since all obstructions due to radiation were in the ileum, whereas 58% of obstructions due to metastases were in the duodenum or jejunum. The radiologic studies interpreted in light of the clinical circumstances were highly accurate in determining the location and nature of small-bowel complications in these patients.