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Original Contributions: PDF Only

Recurrent typhlitis

A disease resulting from aggressive chemotherapy

Keidan, Richard D. M.D.1,2,3; Fanning, James D.O.1,2,3; Gatenby, Robert A. M.D.1,2,3; Weese, James L. M.D.1,2,3

Author Information

2Department of Radiologic Research

Fox Chase Cancer Center

Philadelphia

Pennsylvania

3Department of Diagnostic Imaging and Section of Surgical Oncology

Temple University School of Medicine

Philadelphia

Pennsylvania

1Department of Surgical Oncology

Fox Chase Cancer Center

7701 Burholme Avenue

19111

Philadelphia

Pennsylvania

Diseases of the Colon & Rectum32(3):p 206-209, March 1989. |DOI:10.1007/BF02554529

Abstract

 

Neutropenic typhlitis is a frequently fatal disease most commonly reported in leukemics. The authors have treated eight such patients over the last 18 months. All patients had abdominal pain and sepsis during chemotherapy-induced neutropenia. CT scanning was diagnostic in six patients thought to have typhlitis. Two patients were not diagnosed before exploratory laparotomy. The authors have found nonoperative treatment highly effective in patients who do not manifest signs of peritonitis, perforation, gastrointestinal hemorrhage, or clinical deterioration. Recurrent typhlitis was frequent after conservative therapy (recurrence rate, 67 percent), however. One patient underwent an elective right hemicolectomy after a second episode, and typhlitis did not recur despite neutropenia associated with a subsequent course of chemotherapy. It is concluded that successful treatment of this disease hinges on: 1) early diagnosis provided by a high index of suspicion and the use of CT scanning, 2) nonoperative treatment for uncomplicated cases, and 3) elective right hemicolectomy to prevent recurrence.

© The ASCRS 1989

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Diseases of the Colon & Rectum32(3):206-209, March 1989.
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