Neutropenic colitis: A continuing surgical challenge

Abstract

The greater use of aggressive multiagent chemotherapy regimens may increase the frequency with which the condition is encountered. Heightened awareness of neutropenic colitis may prompt diagnosis and a better understanding of the pathophysiology may help guide clinical management.

Necrotizing enterocolitis in neutropenia and chemotherapy: A clinical update and old lessons relearned

“…The current term is used to describe patients with absolute neutrophil count of less than 1000/μL 3 , fever, and abdominal pain. Other names given to this disease process include ileocecal syndrome, agranulocytic colitis, and cecitis [1,2] The most common locations of the disease, as historically described, are the terminal ileum to the right colon. However, it is now accepted that the terminal ileum to the entire colon can be affected by the condition.…”

Neutropenic enterocolitis (typhilitis) associated with docetaxel therapy in a patient with non-small-cell lung cancer: case report and review of literature

“…Rather than being a specific disease entity, neutropenic colitis probably represents a syndrome of pathological changes [13]. This explains why it has been referred to as several other terms such as typhlitis [14], ileocecal syndrome [15], necrotizing enteropathy [13], and necrotizing enterocolitis [13,16]. The original descriptions of the disease involved children being treated for hematologic malignancies who developed inflammation of the cecum [17].…”

“…The acute inflammatory disease may involve cecum, colon, and terminal part of the ileum. Rather than being a specific disease entity, neutropenic colitis probably represents a syndrome of pathological changes [13]. This explains why it has been referred to as several other terms such as typhlitis [14], ileocecal syndrome [15], necrotizing enteropathy [13], and necrotizing enterocolitis [13,16].…”

Neutropenic patient with fever and abdominal pain

“…The mortality rate can be as high as 21%. It can have disastorous outcomes, such as perforation and intra-abdominal sepsis, but often resolves with withdraw of chemotherapeutic agents and supportive care [1,6,19,20].…”

“…Metz: Neutropenic colitis, a severe necrotizing enteropathy, is a well documented and life-threatening complication of aggressive chemotherapy mainly for lymphoproliferative and hematologic malignancies [1,6,8,19,20].…”