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Neutropenic colitis

Case contributed by Bruno Di Muzio
Diagnosis almost certain

Presentation

Gram-negative sepsis in a background of neutropenia due to chemotherapy for acute myeloid leukemia.

Patient Data

Age: 53-year-old
Gender: Male

CT Abdomen and pelvis

ct

Thickening of the cecal walls associated with mild surrounding fat stranding. The cecal appendix is normal in appearance. Remainder bowel is unremarkable. There is no free fluid or free gas.

A few tiny hypoattenuating foci are identified scattered through the liver, nonspecific, most likely representing small cysts. Liver is otherwise unremarkable.

The spleen, pancreas, kidneys and adrenal glands are normal. There is no lymph node enlargement. No suspicious bone lesions are seen. The lung bases are clear.

Conclusion: Radiographic findings consistent with neutropenic colitis (typhlitis).

Case Discussion

Classical presentation of neutropenic colitis on CT: focal cecal wall thickening and surrounding fat stranding in a patient treating leukemia. 

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