POINTS OF DIFFERENCE AT OPERATION BETWEEN MALIGNANCY AND IRRADIATION INJURY Primary Malignancy

FIG. 1. Results of a barium enema showing a stricture of the descending colon. of Cobalt 60 was given in two parallel opposed fields (15 cm. x 15 cm.), which included the kidney bed and regional lymphatics. A dose of 300 r was given daily alternating between the anterior and posterior portal. A total dose of 5,500 r was delivered over 29 days. The patient remained at work until May 1963 (month 12 from the time of irradiation) when he experienced an episode of severe epigastric pain and nausea. This settled down without treatment but one month later he was admitted to hospital following a week of obstinate constipation, lower abdominal pain, and distension. This too resolved over the following seven days, although a barium enema showed a stricture of the descending colon (Fig. 1).