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Gastrointestinal
Diagnosis
Colon
Infection
Neutropenic Colitis (Typhlitis)
Neutropenic Colitis (Typhlitis)
Atif Zaheer, MD; Michael P. Federle, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Synonyms

                • Neutropenic enterocolitis, ileocecal syndrome

              • Definitions

                • Life-threatening, necrotizing enterocolitis occurring primarily in severely neutropenic patients

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • Ultrasonographic Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Qasim A et al: Neutropenic enterocolitis (typhlitis). StatPearls, 2021
                                            2. Guerri S et al: Clostridium difficile colitis: CT findings and differential diagnosis. Radiol Med. 124(12):1185-98, 2019
                                            3. Tamburrini S et al: Ultrasound diagnosis of typhlitis. J Ultrasound. 22(1):103-6, 2019
                                            4. del Campo L et al: Abdominal complications following hematopoietic stem cell transplantation. Radiographics. 34(2):396-412, 2014
                                            5. Talebian Yazdi A et al: Neutropenic colitis. JBR-BTR. 94(3):138-9, 2011
                                            6. Reyna-Figueroa J et al: Antibiotic use before chemotherapy: a risk factor for developing neutropenic colitis in children with leukemia. J Pediatr Hematol Oncol. 37(2):121-7., 2014
                                            7. Shafey A et al: Incidence, risk factors, and outcomes of enteritis, typhlitis, and colitis in children with acute leukemia. J Pediatr Hematol Oncol. 35(7):514-7, 2013
                                            8. Shvartsbeyn M et al: Pemetrexed-induced typhlitis in non-small cell lung cancer. J Thorac Oncol. 3(10):1188-90, 2008
                                            9. Davila ML: Neutropenic enterocolitis: current issues in diagnosis and management. Curr Infect Dis Rep. 9(2):116-20, 2007
                                            10. McCarville MB: Evaluation of typhlitis in children: CT versus US. Pediatr Radiol. 36(8):890-1, 2006
                                            11. McCarville MB et al: Typhlitis in childhood cancer. Cancer. 104(2):380-7, 2005
                                            12. Gayer G et al: Typhlitis as a rare cause of a psoas abscess. Abdom Imaging. 27(5):600-2, 2002
                                            13. Gayer G et al: Typhlitis: a computed tomography diagnosis. Isr Med Assoc J. 4(2):146-7, 2002
                                            14. Horton KM et al: CT evaluation of the colon: inflammatory disease. Radiographics. 20(2):399-418, 2000
                                            15. Kaste SC et al: Acute lymphoblastic leukemia presenting with typhlitis. Med Pediatr Oncol. 28(3):209-12, 1997
                                            16. Adams GW et al: CT detection of typhlitis. J Comput Assist Tomogr. 9(2):363-5, 1985
                                            17. Frick MP et al: Computed tomography of neutropenic colitis. AJR Am J Roentgenol. 143(4):763-5, 1984
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Pathology

                                                    • Clinical Issues

                                                      • Diagnostic Checklist

                                                        TERMINOLOGY

                                                        • Synonyms

                                                          • Neutropenic enterocolitis, ileocecal syndrome

                                                        • Definitions

                                                          • Life-threatening, necrotizing enterocolitis occurring primarily in severely neutropenic patients

                                                        IMAGING

                                                        • General Features

                                                          • Radiographic Findings

                                                            • CT Findings

                                                              • Ultrasonographic Findings

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Gross Pathologic & Surgical Features

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Qasim A et al: Neutropenic enterocolitis (typhlitis). StatPearls, 2021
                                                                                      2. Guerri S et al: Clostridium difficile colitis: CT findings and differential diagnosis. Radiol Med. 124(12):1185-98, 2019
                                                                                      3. Tamburrini S et al: Ultrasound diagnosis of typhlitis. J Ultrasound. 22(1):103-6, 2019
                                                                                      4. del Campo L et al: Abdominal complications following hematopoietic stem cell transplantation. Radiographics. 34(2):396-412, 2014
                                                                                      5. Talebian Yazdi A et al: Neutropenic colitis. JBR-BTR. 94(3):138-9, 2011
                                                                                      6. Reyna-Figueroa J et al: Antibiotic use before chemotherapy: a risk factor for developing neutropenic colitis in children with leukemia. J Pediatr Hematol Oncol. 37(2):121-7., 2014
                                                                                      7. Shafey A et al: Incidence, risk factors, and outcomes of enteritis, typhlitis, and colitis in children with acute leukemia. J Pediatr Hematol Oncol. 35(7):514-7, 2013
                                                                                      8. Shvartsbeyn M et al: Pemetrexed-induced typhlitis in non-small cell lung cancer. J Thorac Oncol. 3(10):1188-90, 2008
                                                                                      9. Davila ML: Neutropenic enterocolitis: current issues in diagnosis and management. Curr Infect Dis Rep. 9(2):116-20, 2007
                                                                                      10. McCarville MB: Evaluation of typhlitis in children: CT versus US. Pediatr Radiol. 36(8):890-1, 2006
                                                                                      11. McCarville MB et al: Typhlitis in childhood cancer. Cancer. 104(2):380-7, 2005
                                                                                      12. Gayer G et al: Typhlitis as a rare cause of a psoas abscess. Abdom Imaging. 27(5):600-2, 2002
                                                                                      13. Gayer G et al: Typhlitis: a computed tomography diagnosis. Isr Med Assoc J. 4(2):146-7, 2002
                                                                                      14. Horton KM et al: CT evaluation of the colon: inflammatory disease. Radiographics. 20(2):399-418, 2000
                                                                                      15. Kaste SC et al: Acute lymphoblastic leukemia presenting with typhlitis. Med Pediatr Oncol. 28(3):209-12, 1997
                                                                                      16. Adams GW et al: CT detection of typhlitis. J Comput Assist Tomogr. 9(2):363-5, 1985
                                                                                      17. Frick MP et al: Computed tomography of neutropenic colitis. AJR Am J Roentgenol. 143(4):763-5, 1984