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Pediatrics
Diagnosis
Gastrointestinal
Abnormalities in Immunocompromised Children
Neutropenic Colitis
Neutropenic Colitis
Michael R. Aquino, MD, MHSc
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Synonyms

              • Typhlitis, ileocecal syndrome, neutropenic enterocolitis, cecitis, necrotizing enteropathy

            • Definitions

              • Necrotizing inflammatory process of bowel most commonly affecting right colon of neutropenic patients (with absolute neutrophil count < 500 cells/μL)

            IMAGING

            • General Features

              • Radiographic Findings

                • Fluoroscopic Findings

                  • CT Findings

                    • Ultrasonographic Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            CLINICAL ISSUES

                            • Presentation

                              • Natural History & Prognosis

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Consider

                                    • Image Interpretation Pearls

                                      Selected References

                                      1. Concepcion NDP et al: Imaging assessment of complications from transplantation from pediatric to adult patients: part 2: hematopoietic stem cell transplantation. Radiol Clin North Am. 58(3):569-82, 2020
                                      2. Handa A et al: Pediatric oncologic emergencies: clinical and imaging review for pediatricians. Pediatr Int. 61(2):122-39, 2019
                                      3. Pelletier JH et al: Neutropenic enterocolitis (typhlitis) in a pediatric renal transplant patient. A case report and review of the literature. Pediatr Transplant. 21(6), 2017
                                      4. Chavhan GB et al: Imaging of acute and subacute toxicities of cancer therapy in children. Pediatr Radiol. 46(1):9-20; quiz 6-8, 2016
                                      5. Sundell N et al: Management of neutropenic enterocolitis in children with cancer. Acta Paediatr. 101(3):308-12, 2012
                                      6. Fike FB et al: Neutropenic colitis in children. J Surg Res. 170(1):73-6, 2011
                                      7. Cloutier RL: Neutropenic enterocolitis. Hematol Oncol Clin North Am. 24(3):577-84, 2010
                                      8. Rizzatti M et al: Neutropenic enterocolitis in children and young adults with cancer: prognostic value of clinical and image findings. Pediatr Hematol Oncol. 27(6):462-70, 2010
                                      9. Mullassery D et al: Diagnosis, incidence, and outcomes of suspected typhlitis in oncology patients--experience in a tertiary pediatric surgical center in the United Kingdom. J Pediatr Surg. 44(2):381-5, 2009
                                      10. Ullery BW et al: Neutropenic enterocolitis. Surg Infect (Larchmt). 10(3):307-14, 2009
                                      11. Davila ML: Neutropenic enterocolitis: current issues in diagnosis and management. Curr Infect Dis Rep. 9(2):116-20, 2007
                                      12. McCarville MB et al: Typhlitis in childhood cancer. Cancer. 104(2):380-7, 2005
                                      13. Kirkpatrick ID et al: Gastrointestinal complications in the neutropenic patient: characterization and differentiation with abdominal CT. Radiology. 226(3):668-74, 2003
                                      14. Horton KM et al: CT evaluation of the colon: inflammatory disease. Radiographics. 20(2):399-418, 2000
                                      15. Sloas MM et al: Typhlitis in children with cancer: a 30-year experience. Clin Infect Dis. 17(3):484-90, 1993
                                      16. Moir CR et al: Typhlitis: selective surgical management. Am J Surg. 151(5):563-6, 1986
                                      17. Shamberger RC et al: The medical and surgical management of typhlitis in children with acute nonlymphocytic (myelogenous) leukemia. Cancer. 57(3):603-9, 1986
                                      18. Adams GW et al: CT detection of typhlitis. J Comput Assist Tomogr. 9(2):363-5, 1985
                                      19. 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

                                                TERMINOLOGY

                                                • Synonyms

                                                  • Typhlitis, ileocecal syndrome, neutropenic enterocolitis, cecitis, necrotizing enteropathy

                                                • Definitions

                                                  • Necrotizing inflammatory process of bowel most commonly affecting right colon of neutropenic patients (with absolute neutrophil count < 500 cells/μL)

                                                IMAGING

                                                • General Features

                                                  • Radiographic Findings

                                                    • Fluoroscopic Findings

                                                      • CT Findings

                                                        • Ultrasonographic Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                CLINICAL ISSUES

                                                                • Presentation

                                                                  • Natural History & Prognosis

                                                                    • Treatment

                                                                      DIAGNOSTIC CHECKLIST

                                                                      • Consider

                                                                        • Image Interpretation Pearls

                                                                          Selected References

                                                                          1. Concepcion NDP et al: Imaging assessment of complications from transplantation from pediatric to adult patients: part 2: hematopoietic stem cell transplantation. Radiol Clin North Am. 58(3):569-82, 2020
                                                                          2. Handa A et al: Pediatric oncologic emergencies: clinical and imaging review for pediatricians. Pediatr Int. 61(2):122-39, 2019
                                                                          3. Pelletier JH et al: Neutropenic enterocolitis (typhlitis) in a pediatric renal transplant patient. A case report and review of the literature. Pediatr Transplant. 21(6), 2017
                                                                          4. Chavhan GB et al: Imaging of acute and subacute toxicities of cancer therapy in children. Pediatr Radiol. 46(1):9-20; quiz 6-8, 2016
                                                                          5. Sundell N et al: Management of neutropenic enterocolitis in children with cancer. Acta Paediatr. 101(3):308-12, 2012
                                                                          6. Fike FB et al: Neutropenic colitis in children. J Surg Res. 170(1):73-6, 2011
                                                                          7. Cloutier RL: Neutropenic enterocolitis. Hematol Oncol Clin North Am. 24(3):577-84, 2010
                                                                          8. Rizzatti M et al: Neutropenic enterocolitis in children and young adults with cancer: prognostic value of clinical and image findings. Pediatr Hematol Oncol. 27(6):462-70, 2010
                                                                          9. Mullassery D et al: Diagnosis, incidence, and outcomes of suspected typhlitis in oncology patients--experience in a tertiary pediatric surgical center in the United Kingdom. J Pediatr Surg. 44(2):381-5, 2009
                                                                          10. Ullery BW et al: Neutropenic enterocolitis. Surg Infect (Larchmt). 10(3):307-14, 2009
                                                                          11. Davila ML: Neutropenic enterocolitis: current issues in diagnosis and management. Curr Infect Dis Rep. 9(2):116-20, 2007
                                                                          12. McCarville MB et al: Typhlitis in childhood cancer. Cancer. 104(2):380-7, 2005
                                                                          13. Kirkpatrick ID et al: Gastrointestinal complications in the neutropenic patient: characterization and differentiation with abdominal CT. Radiology. 226(3):668-74, 2003
                                                                          14. Horton KM et al: CT evaluation of the colon: inflammatory disease. Radiographics. 20(2):399-418, 2000
                                                                          15. Sloas MM et al: Typhlitis in children with cancer: a 30-year experience. Clin Infect Dis. 17(3):484-90, 1993
                                                                          16. Moir CR et al: Typhlitis: selective surgical management. Am J Surg. 151(5):563-6, 1986
                                                                          17. Shamberger RC et al: The medical and surgical management of typhlitis in children with acute nonlymphocytic (myelogenous) leukemia. Cancer. 57(3):603-9, 1986
                                                                          18. Adams GW et al: CT detection of typhlitis. J Comput Assist Tomogr. 9(2):363-5, 1985
                                                                          19. Frick MP et al: Computed tomography of neutropenic colitis. AJR Am J Roentgenol. 143(4):763-5, 1984