Neutropaenic enterocolitis

Case contributed by Jan Frank Gerstenmaier
Diagnosis almost certain

Presentation

This patient had received induction chemotherapy with cytarabine and daunorubicine for acute myeolid leukemia. He developed abdominal pain, diarrhea and fever. The neutrophil count was 200 cells/microliter (normal >1,500 cells/microliter)

Patient Data

Age: 65
Gender: Male

CT abdomen with oral & C+

ct

The cecum, right colon, transverse colon and left colon as well as the distal 30cm or so of the ileum are thick walled and oedemtous. The sigmoid colon is spared. No obstruction or megacolon. No perforation or abscess. No lymphadenopathy.

Case Discussion

A combination of localized and systemic symptoms is typical for neutropaenic enterocolitis. The right colon is most commonly affected, but in the neutropaenic patient, this condition should be considered even if only small bowel is involved.

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