Typhlitis

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[edit] Discussion

  • AKA neutropenic enterocolitis
  • Occurs in neutropenic patients undergoing treatment for a malignancy, most frequently patients with acute leukemia who are receiving chemotherapy.
  • Also been reported in patients with aplastic anemia, lymphoma, or acquired immunodeficiency syndrome and after kidney transplantation.
  • Typhlitis is characterized by edema and inflammation of the cecum, the ascending colon, and sometimes the terminal ileum.
  • The inflammation can be so severe that transmural necrosis, perforation, and death can result.
  • The mechanism of the condition is not known, but it is probably due to a combination of ischemia, infection (especially with cytomegalovirus), mucosal hemorrhage, and perhaps neoplastic infiltration.
  • Treatment consists of bowel rest, total parenteral nutrition, antibiotics, and aggressive fluid and electrolyte replacement.

[edit] Imaging Findings

[edit] CT

  • Cecal distention and circumferential thickening of the cecal wall
  • Inflammatory stranding of the adjacent mesenteric fat is a common finding.
  • Detection of complications such as pneumatosis, pneumoperitoneum, and pericolic fluid collections is important because they indicate a need for urgent surgical management.

[edit] Images

Patient #1

[edit] See Also

[edit] External Links

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