Tuğrul ELVERDİ, Abdullah Kağan ZENGİN, Mehmet VELİDEDEOĞLU, Ahmet Necati ŞANLI, Server Sezgin ULUDAĞ, Salih PEKMEZCİ, Emre TUNÇ, Osman ŞİMŞEK

Surgical and clinical management of neutropenic enterocolitis seen in hematological and solid organ malignancies

Aim: Ileocecal syndrome also called typhilite; It is defined as inflammation of the cecum and surrounding tissues seen in immunosuppressed patients. Typhilite is a serious disease in the ileum, cecum, and ascending colon with segmental inflammation and necrosis due to ulceration. The disease has difficulties in its diagnosis, treatment, and surgery. We aimed to examine the difficulties in diagnosis and treatment in this disease, which has high morbidity and mortality.Materials and Methods: Patients who have hematological or solid organ malignancies, diagnosed with neutropenic enterocolitis between January 2014 and December 2019 were included in the study. The demographic information, malignancies, chemotherapy treatments, follow-ups, clinical symptoms, laboratory, and radiology findings of the patients were examined.Results: A total of 7 patients were identified between the dates indicated, 4 were male and 3 were female. The mean age was 58.5. Six of these patients had hematological and one had solid organ malignancy. All patients had the typical fever (above 38), non-migratory abdominal pain localized to the right lower quadrant, and neutropenia (

PDF

___

1. Katz JA, Mahoney Jr DH, Fernbach DJ, et al. Typhlitis. An 18-year experience and postmortem review. Cancer 1990;65:1041-7.
2. Urbach DR, Rotstein OD. Typhlitis. Can J Surg 1999;42:415-9.
3. Wade DS, Nava HR, Douglass HO. Neutropenic enterocolitis. Clinical diagnosis and treatment. Cancer 1992;69:17-23.
4. Kaste SC, Flynn PM, Furman WL. Acute lymphoblastic leukemia presenting with typhlitis. Med Pediatr Oncol 1997;28:209-12.
5. Bibbo C, Barbieri RA, Deitch EA, Brolin RE. Neutropenic enterocolitis in a trauma patient during antibiotic therapy for osteomyelitis. J Trauma 2000;49:760-3.
6. Davila ML. Neutropenic enterocolitis. Curr Opin Gastroenterol 2006;22:44-7.
7. Gorschlüter M, Mey U, Strehl J, et al. Neutropenic enterocolitis in adults: systematic analysis of evidence quality. Eur J Haematol 2005;75:1-13.
8. Song HK, Krisel D, Canter R, et al. Changing presentation and management of neutropenic enterocolitis. Arch Surg 1998;133:979-82
9. Sloas MM, Flynn PM, Kaste SC, et al. Typhlitis in children with cancer: a 30-year experience. Clin Infect Dis 1993;17:484-90.
10. Pokorney BH, Jones JM, Shaikh BS, et al. Typhlitis: a treatable cause of recurrent septicemia. JAMA 1980;243:682-3.
11. Rodrigues FG, Dasilva G, Wexner SD. Neutropenic Enterocolitis. World J. Gastroenterol 2017;23:42-7.
12. Saillard C, Zafrani L, Darmon M, et al. The prognostic impact of abdominal surgery in cancer patients with neutropenic enterocolitis: a systematic review and meta-analysis, on behalf the Groupe de Recherche en Réanimation Respiratoire du patient d'Onco- Hématologie (GRRR-OH). Ann Intensive Care 2018;8:47.