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Cureus 2022 Apr 25;14(4):e24475. Epub 2022 Apr 25.

Department of Hematology, Faculty of Medicine, Mohammed VI University of Health Sciences (UM6SS), Casablanca, MAR.

Neutropenic enterocolitis (NE) is a rare but severe complication occurring in neutropenic patients undergoing intensive chemotherapy. Mortality is high, so early diagnosis is required to start urgent medical or surgical treatment. Data analysis of the development of NE after hematopoietic stem cell transplantation remains scarce. Read More

Can Vet J 2021 11;62(11):1190-1194

Department of Large Animal Clinical Sciences (Cruz Villagrán, Vogt) and Department of Veterinary Pathology (Gupta, Aburto), Western College of Veterinary Medicine, The University of Saskatchewan, 52 Campus Drive, Saskatoon, Saskatchewan S7N 5B4.

A 3-year-old Quarter Horse gelding was evaluated for chronic weight loss, diarrhea, and pruritus. Physical examination revealed several ulcerative lesions on the skin and mucosal membranes. Diagnostic imaging findings were consistent with enteritis, typhlitis, and colitis. Read More

Medicina (Kaunas) 2021 Jun 20;57(6). Epub 2021 Jun 20.

Section of Legal Medicine, Department of Clinical and Experimental Medicine, University of Foggia, Ospedale Colonnello D'Avanzo, Viale Europa 12, 71100 Foggia, Italy.

Neutropenic enterocolitis (NE), which in the past was also known as typhlitis or ileocecal syndrome for the segment of the gastrointestinal tract most affected, is a nosological entity that is difficult to diagnose and whose pathogenesis is not fully known to date. Initially described in pediatric patients with leukemic diseases, it has been gradually reported in adults with hematological malignancies and non-hematological conditions, such as leukemia, lymphoma, multiple myeloma, aplastic anemia, and also myelodysplastic syndromes, as well as being associated with other immunosuppressive causes such as AIDS treatment, therapy for solid tumors, and organ transplantation. Therefore, it is associated with high mortality due to the rapid evolution in worse clinical pictures: rapid progression to ischemia, necrosis, hemorrhage, perforation, multisystem organ failure, and sepsis. Read More

Sci Rep 2021 06 9;11(1):12170. Epub 2021 Jun 9.

Department of Pediatric Hematology and Oncology, St. Anna Children's Hospital, Medical University of Vienna, Kinderspitalgasse 6, 1090, Vienna, Austria.

Acute appendicitis is a rare gastrointestinal complication of anti-cancer chemotherapy and hematopoietic stem cell transplantation. Among a cohort of 2341 hemato-oncologic patients at a pediatric tertiary care cancer center, we identified 21 patients (0.9%) with 23 episodes of acute appendicitis, based on pathological imaging of the appendix and clinical findings. Read More

Dtsch Med Wochenschr 2021 04 14;146(8):511-512. Epub 2021 Apr 14.

Radiologie 360°, Leitung Praxis des MVZ Med 360° Eschweiler, Eschweiler, Deutschland.

Am J Emerg Med 2021 07 4;45:685.e1-685.e3. Epub 2021 Jan 4.

Department of Infectious Disease, School of Medicine, Pamukkale University, 20100 Denizli, Turkey.

Neutropenic enterocolitis is also known as typhlitis, is characterized by severe inflammation in the bowel loops. It is often seen in immunosuppressed patients, and it has high morbidity and mortality. Although the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) primarily affects the respiratory system and causes COVID-19 (Coronavirus Disease 2019), it may affect hematopoietic and gastrointestinal systems. Read More

Cureus 2020 Nov 17;12(11):e11523. Epub 2020 Nov 17.

Acute Care Surgery, Hamad Medical Corporation, Doha, QAT.

Abdominal symptoms in patients with hematological malignancies can occur due to an array of pathologies. Two diagnoses with similar presentation albeit, generally opposite treatment modalities, are typhlitis (inflammation of cecum) and acute appendicitis. Both diagnoses have to be kept in mind in such a patient presenting with right lower quadrant (RLQ) pain. Read More

Int J Colorectal Dis 2019 Oct 11;34(10):1815-1818. Epub 2019 Sep 11.

Division of Hematology and Oncology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Introduction: Intussusception, which is common in pediatric patients but rare in adults with leukemia, usually presents with an intralumenal lesion as a lead point in adults.

Case Report: We herein report the case of a 38-year-old female who developed right lower quadrant abdominal pain and fever on day 16 of chemotherapy. Abdominal computed tomography showed ileocecal intussusception. Read More

Radiol Med 2019 Dec 13;124(12):1185-1198. Epub 2019 Jul 13.

Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Largo G.A. Brambilla 3, 50134, Florence, Italy.

Clostridium difficile infection (CDI) is a severe and potentially deadly infectious colitis whose incidence is dramatically increasing in the last decades, with more virulent strains. CDI should be suspected in case of unexplained diarrhea and abdominal pain in patients with a recent history of antibiotic use and healthcare exposures; diagnosis is based on a combination of clinical and laboratory findings with demonstration of C. difficile toxins by stool test. Read More

J Ultrasound 2019 Mar 27;22(1):103-106. Epub 2018 Oct 27.

Department of Radiology-Ospedale del Mare-ASL NA1 Centro-Napoli, Naples, Italy.

Purpose: Typhlitis, also known as neutropenic colitis, is a rare inflammatory condition and a potentially life-threatening disease process that typically involves the cecum. Delay in diagnosis may lead to a fatal prognosis with a death rate of 21-48%. Ultrasound evaluation of right lower quadrant may lead to an accurate and rapid diagnosis. Read More

J Med Case Rep 2018 Aug 16;12(1):221. Epub 2018 Aug 16.

Department of Colorectal Surgery, Westmead Hospital, Cnr Hawkesbury Road and Darcy Road, Westmead, NSW, 2145, Australia.

Background: Paclitaxel is a chemotherapy drug commonly used in the management of ovarian cancer. Colonic perforation is an extremely rare complication of paclitaxel administration with few case reports in the medical literature. We report a case of a patient with advanced ovarian cancer who had a rectal perforation following administration of paclitaxel. Read More

Leuk Res 2018 05 8;68:48-50. Epub 2018 Mar 8.

Leukemia Service, Division of Hematologic Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Background: The current standard of care for the treatment of patients with newly diagnosed acute myeloid leukemia (AML) is an anthracycline plus cytarabine. Both anthracyclines and cytarabine have been associated with the development of typhlitis, a serious adverse event characterized by inflammation of the bowel wall in patients with profound neutropenia, diagnosed by abdominal CT imaging and clinical symptoms. Given the paucity of available data, the aim of our study was to determine the incidence of typhlitis among AML patients receiving induction chemotherapy with idarubicin 12 mg/m (IDA), daunorubicin 60 mg/m (DNA60), or daunorubicin 90 mg/m (DNA90). Read More

J Gastroenterol Hepatol 2018 Apr;33(4):769

Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Comp Med 2017 Dec;67(6):524-528

Department of Pathology, College of Veterinary Medicine, University of Georgia, Athens, Georgia.

An adult feline blood donor, group-housed in a closed colony with other blood donor cats in a laboratory animal facility, developed anorexia, abdominal pain, an abdominal mass effect, and hemorrhagic diarrhea. Ultimately Salmonella infection was diagnosed. The index cat and 2 additional cats in the closed colony had clinical signs consistent with Salmonella and yielded Salmonella serotype 4,12:i:- in fecal cultures. Read More

Expert Rev Hematol 2017 Feb 23;10(2):169-174. Epub 2017 Jan 23.

a Department of Internal Medicine , University Hospital, Universidade Federal do Rio de Janeiro , Rio de Janeiro , Brazil.

Introduction: Typhlitis is an abdominal complication of cancer chemotherapy, affecting mostly patients receiving intensive chemotherapeutic regimens with high potential to induce mucosal damage, such as patients with acute leukemia. Despite being relatively frequent, there are no randomized trials or high-quality cohort studies addressing important aspects of the diagnosis and management of the disease. Areas covered: In this review we discuss the gaps in the literature, acknowledging that the evidences for recommendations regarding the management of typhlitis are mostly expert opinion. Read More

J Feline Med Surg 2017 02 25;19(2):94-104. Epub 2016 Sep 25.

2 Department of Internal Medicine, University Paris-Est Créteil, National Veterinary School of Alfort, Maisons-Alfort, France.

Objectives This study aimed to describe the ultrasonographic, endoscopic and histological characteristics of the caecum and ileocaecocolic junction in cats suffering from chronic clinical signs compatible with caecocolic disease. Methods Cats presenting with clinical signs suggestive of a caecocolic disease were prospectively recruited. All cats underwent an ultrasonographic examination of the caecum, ileum, colon, ileocolic lymph nodes and local mesenteric fat, in addition to comprehensive abdominal ultrasonography. Read More

Lancet Infect Dis 2016 05 18;16(5):618. Epub 2016 Apr 18.

Department of Haematology, St George's Hospital, London, UK.

Praxis (Bern 1994) 2015 Dec;104(25):1414-6

1 Institut für Sonographie, Uster.

Radiol Clin North Am 2015 Nov 12;53(6):1255-71. Epub 2015 Aug 12.

Section of Abdominal Imaging, Imaging Institute, Digestive Disease Institute and Cancer Institute, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, L10, 9500 Euclid Avenue, Cleveland, OH 44195, USA. Electronic address:

Infectious and inflammatory enterocolitides can present with an acute abdomen. The most common entities are ulcerative colitis, Crohn disease, and Clostridium difficile colitis. This article reviews the clinical and imaging findings of patients who present acutely with infectious and inflammatory enterocolitides. Read More

Chirurg 2014 Nov;85(11):1010-1

J Patient Saf 2014 Sep;10(3):154-8

From the Department of Emergency Medicine, Case Western Reserve University, MetroHealth Medical Center, Cleveland, Ohio.

Study Objectives: The American College of Radiology lists oral contrast as an institution-specific option in the evaluation of right lower quadrant pain. Previous literature indicates that an accurate assessment for appendicitis can be made by CT using IV contrast alone, with significant time savings from withholding oral contrast. Before 2010, the protocol for CT use in the evaluation of possible appendicitis or undifferentiated abdominal pain routinely included oral contrast. Read More

J Med Primatol 2013 Dec 12;42(6):336-42. Epub 2013 Aug 12.

Department of Veterinary Medicine, Federal University of Paraná, Curitiba, Paraná, Brazil.

Background: The acute abdomen is any abdominal disorder resulting in pain, shock, or sepsis. Although it has a multifactorial etiology, the primary cause is gastrointestinal tract pathology. The aim of this study was to assess the contribution of abdominal ultrasound as a complementary diagnostic tool in non-human primates with an acute abdomen. Read More

J Pediatr Hematol Oncol 2013 Oct;35(7):514-7

Departments of Pediatrics and Diagnostic Imaging, and Program in Child Health Evaluative Sciences, Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada.

This retrospective chart review describes pediatric patients with acute lymphoblastic leukemia or acute myeloid leukemia diagnosed between January 1999 and January 2008, who were identified with enteritis, typhlitis, or colitis. Among the acute leukemia patients, 33/449 (7.3%) with acute lymphoblastic leukemia and 13/89 (14. Read More

BMJ Case Rep 2013 Apr 17;2013. Epub 2013 Apr 17.

Department of Medicine, Albert Einstein Medical Center, Philadelphia, Pennsylvania, USA.

Typhlitis or neutropenic enterocolitis (NEC) is a life-threatening condition that occurs in neutropenic patients. Early recognition is crucial owing to high death rate. We present a case of a 54-year-old man, diagnosed with non-Hodgkin lymphoma who received a first cycle of rituximab, cyclophosphamide, hydroxydaunorubicin (doxorubicin), oncovin (vincristine), prednisolone (R-CHOP) chemotherapy 10 days prior presenting. Read More

Med Princ Pract 2012 20;21(1):36-9. Epub 2011 Oct 20.

Department of Pediatric Hematology, Dr. Sami Ulus Children's Hospital, Ankara, Turkey.

Objective: To review our experience with typhlitis among children treated for acute leukemia.

Material And Methods: The medical records of children with acute leukemia and typhlitis between 2006 and 2009 were reviewed for demographics and symptoms, and for microbiological and imaging findings.

Results: In the 75 children with acute leukemia--54 with acute lymphoblastic leukemia (ALL) and 21 with acute myeloid leukemia (AML)--there were 10 episodes of typhlitis (4. Read More

Acta Paediatr 2012 Mar 14;101(3):308-12. Epub 2011 Oct 14.

Department of Pediatrics, Institution of Clinical Sciences, Sahlgrenska University Hospital, Gothenburg, Sweden.

Aim: To describe the symptoms, clinical management and short-term outcome in a series of paediatric oncology patients with severe typhlitis following conservative treatment.

Methods: Twelve episodes of severe typhlitis in 11 children with cancer treated at the paediatric oncology ward at Queen Silvias Children's Hospital between 1995 and 2006 were analysed retrospectively. Data on symptoms, radiological findings, laboratory status and treatment as well as outcome were collected and analysed. Read More

Pediatr Blood Cancer 2011 Oct 24;57(4):620-4. Epub 2011 Jan 24.

Children's Hospital and Research Center, Oakland, California 94609, USA.

Background: Prolonged febrile neutropenia (FN) remains a common problem in pediatric oncology and often leads to empiric computed tomography (CT) of the sinuses, chest, abdomen, and pelvis. Little evidence is available as to the diagnostic utility of CT in this setting.

Procedure: We performed a retrospective review of all oncology patients admitted to the hospital from January 2004 through December 2008 for FN who had daily fevers with neutropenia for 4 or more consecutive days prompting CT evaluation. Read More

BMJ Case Rep 2011 Sep 13;2011. Epub 2011 Sep 13.

Department of General Surgery, University College Hospital, London, UK.

Rofo 2010 Dec 12;182(12):1076-81. Epub 2010 Nov 12.

Department of Diagnostic and Interventional Radiology, Eberhard-Karls-Universität, Tübingen.

Purpose: This study investigates the features of neutropenic enterocolitis (NE) in adults.

Materials And Methods: Chart and radiology report reviews were used to identify neutropenic patients with hematological diseases undergoing chemotherapy, who had CT scans for the clarification of abdominal symptoms between October 2003 and October 2009. Patients with any cause for enteritis other than NE were excluded. Read More

Radiographics 2010 Nov;30(7):1843-56

Department of Radiology, University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, Box 218, Hills Rd, Cambridge, CB2 0QQ, England.

Gynecologic malignancies account for 10%-15% of all malignancies in females. A variety of oncologic options are available depending on organ of origin, histologic diagnosis, and disease grade and stage. Gynecologic malignancies are usually treated with surgery, chemotherapy, or radiation therapy. Read More