Neutropenic enterocolitis - Revision history

Ostermayer: Prepared the page for translation

2026-01-04T23:48:20Z

Prepared the page for translation

← Revisión anterior		Revisión del 23:48 4 ene 2026
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	==Background==		==Background==

	[[File:Diameters of the large intestine.png\|thumb\|Average inner diameters and ranges of different sections of the large intestine.<ref> Nguyen H, Loustaunau C, Facista A, Ramsey L, Hassounah N, Taylor H, et al. (July 2010). "Deficient Pms2, ERCC1, Ku86, CcOI in field defects during progression to colon cancer". Journal of Visualized Experiments (41). doi:10.3791/1931. PMC 3149991. PMID 20689513.</ref>]]		[[File:Diameters of the large intestine.png\|thumb\|Average inner diameters and ranges of different sections of the large intestine.<ref> Nguyen H, Loustaunau C, Facista A, Ramsey L, Hassounah N, Taylor H, et al. (July 2010). "Deficient Pms2, ERCC1, Ku86, CcOI in field defects during progression to colon cancer". Journal of Visualized Experiments (41). doi:10.3791/1931. PMC 3149991. PMID 20689513.</ref>]]
	*Also known as "typhlitis"		*Also known as "typhlitis"
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	**Involves terminal ileum and colon		**Involves terminal ileum and colon
	**May progress to full-thickness infarction/perforation		**May progress to full-thickness infarction/perforation


	==Clinical Features==		==Clinical Features==

	*Typically presents 10-14d after cytotoxic therapy		*Typically presents 10-14d after cytotoxic therapy
	*[[neutropenic fever\|Fever]]		*[[Special:MyLanguage/neutropenic fever\|Fever]]
	*[[RLQ pain]]		*[[Special:MyLanguage/RLQ pain\|RLQ pain]]
	*[[Nausea/vomiting]]		*[[Special:MyLanguage/Nausea/vomiting\|Nausea/vomiting]]


	==Differential Diagnosis==		==Differential Diagnosis==

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	{{Oncologic emergencies DDX}}		{{Oncologic emergencies DDX}}
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	{{Abd DDX RLQ}}		{{Abd DDX RLQ}}
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	==Evaluation==		==Evaluation==


	===Workup<ref>Machado NO. Neutropenic enterocolitis: A continuing medical and surgical challenge. N Am J Med Sci. 2010 Jul; 2(7): 293–300.</ref>===		===Workup<ref>Machado NO. Neutropenic enterocolitis: A continuing medical and surgical challenge. N Am J Med Sci. 2010 Jul; 2(7): 293–300.</ref>===
	*CBC with [[neutropenia]], [[thrombocytopenia]]
			*CBC with [[Special:MyLanguage/neutropenia\|neutropenia]], [[Special:MyLanguage/thrombocytopenia\|thrombocytopenia]]
	*Blood cultures positive in ~25-85%, frequently bowel organisms		*Blood cultures positive in ~25-85%, frequently bowel organisms
	*CT A/P: cecal distention, wall thickening, pneumatosis intestinalis, intestinal perforation, fat stranding		*CT A/P: cecal distention, wall thickening, pneumatosis intestinalis, intestinal perforation, fat stranding
	*Avoid endoscopic evaluation due to risk of perforation, hemorrhage, bacterial translocation, worsening sepsis		*Avoid endoscopic evaluation due to risk of perforation, hemorrhage, bacterial translocation, worsening sepsis


	==Management==		==Management==

	*Bowel rest		*Bowel rest
	*[[NG tube]] to suction		*[[Special:MyLanguage/NG tube\|NG tube]] to suction
	*[[IVF]]		*[[Special:MyLanguage/IVF\|IVF]]
	*TPN		*TPN
	*Consider G-CSF, particularly neutropenia < 100/ml and severe disease<ref>Greil R, Psenak O, Roila F. ESMO Guidelines Working Group. Hematopoietic growth factors: ESMO recommendations for the applications. Ann Oncol. 2008;19(suppl 2:ii):116–1118.</ref>		*Consider G-CSF, particularly neutropenia < 100/ml and severe disease<ref>Greil R, Psenak O, Roila F. ESMO Guidelines Working Group. Hematopoietic growth factors: ESMO recommendations for the applications. Ann Oncol. 2008;19(suppl 2:ii):116–1118.</ref>
	*Broad spectrum antimicrobials, in particular against gut microbiota to include<ref>Gorschluter M, Mey U, Strehl J, Zinske C, Schepke M, Schmid F, Wolf IG, Sauerbruch T, Glasmacher A, et al. Neutropenic enterocolitis in adults: systematic analysis of evidence quality. Eur J Haematol. 2005;75(1):1–13.</ref>:		*Broad spectrum antimicrobials, in particular against gut microbiota to include<ref>Gorschluter M, Mey U, Strehl J, Zinske C, Schepke M, Schmid F, Wolf IG, Sauerbruch T, Glasmacher A, et al. Neutropenic enterocolitis in adults: systematic analysis of evidence quality. Eur J Haematol. 2005;75(1):1–13.</ref>:
	**[[Metronidazole]] plus [[cefepime]]		**[[Special:MyLanguage/Metronidazole\|Metronidazole]] plus [[Special:MyLanguage/cefepime\|cefepime]]
	**[[Piperacillin-tazobactam]]		**[[Special:MyLanguage/Piperacillin-tazobactam\|Piperacillin-tazobactam]]
	**[[Amphotericin B]] when patient remains febrile, neutropenic for greater than 5 days despite broad spectrum antibiotics		**[[Special:MyLanguage/Amphotericin B\|Amphotericin B]] when patient remains febrile, neutropenic for greater than 5 days despite broad spectrum antibiotics
	*Surgical consult (possible need for right hemicolectomy)<ref>Williams N, Scott AD. Neutropaenic enterocolitis : a continuing surgical challenge. Br J Surg. 1997;84(9):1200–1205.</ref>		*Surgical consult (possible need for right hemicolectomy)<ref>Williams N, Scott AD. Neutropaenic enterocolitis : a continuing surgical challenge. Br J Surg. 1997;84(9):1200–1205.</ref>


	==Disposition==		==Disposition==

	*Admit		*Admit


	==See Also==		==See Also==
	*[[Neutropenic fever]]
			*[[Special:MyLanguage/Neutropenic fever\|Neutropenic fever]]


	==References==		==References==

	<references/>		<references/>

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	[[category:Surgery]]		[[category:Surgery]]
	[[Category:Heme/Onc]]		[[Category:Heme/Onc]]
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Rossdonaldson1: Rossdonaldson1 moved page Neutropenic enterocolitis (typhlitis) to Neutropenic enterocolitis

2025-09-24T21:10:27Z

Rossdonaldson1 moved page Neutropenic enterocolitis (typhlitis) to Neutropenic enterocolitis

← Revisión anterior	Revisión del 21:10 24 sep 2025
(Sin diferencias)

Rossdonaldson1: /* Background */

2025-09-24T21:10:13Z

Background

← Revisión anterior		Revisión del 21:10 24 sep 2025
Línea 1:		Línea 1:
	==Background==		==Background==
	[[File:Diameters of the large intestine.png\|thumb\|Average inner diameters and ranges of different sections of the large intestine.<ref> Nguyen H, Loustaunau C, Facista A, Ramsey L, Hassounah N, Taylor H, et al. (July 2010). "Deficient Pms2, ERCC1, Ku86, CcOI in field defects during progression to colon cancer". Journal of Visualized Experiments (41). doi:10.3791/1931. PMC 3149991. PMID 20689513.</ref>]]		[[File:Diameters of the large intestine.png\|thumb\|Average inner diameters and ranges of different sections of the large intestine.<ref> Nguyen H, Loustaunau C, Facista A, Ramsey L, Hassounah N, Taylor H, et al. (July 2010). "Deficient Pms2, ERCC1, Ku86, CcOI in field defects during progression to colon cancer". Journal of Visualized Experiments (41). doi:10.3791/1931. PMC 3149991. PMID 20689513.</ref>]]
			*Also known as "typhlitis"
	*Necrosis of bowel wall secondary to polymicrobial invasion		*Necrosis of bowel wall secondary to polymicrobial invasion
	**Involves terminal ileum and colon		**Involves terminal ileum and colon

Rossdonaldson1: /* Background */

2025-09-24T21:04:58Z

Background

← Revisión anterior		Revisión del 21:04 24 sep 2025
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	==Background==		==Background==
			[[File:Diameters of the large intestine.png\|thumb\|Average inner diameters and ranges of different sections of the large intestine.<ref> Nguyen H, Loustaunau C, Facista A, Ramsey L, Hassounah N, Taylor H, et al. (July 2010). "Deficient Pms2, ERCC1, Ku86, CcOI in field defects during progression to colon cancer". Journal of Visualized Experiments (41). doi:10.3791/1931. PMC 3149991. PMID 20689513.</ref>]]
	*Necrosis of bowel wall secondary to polymicrobial invasion		*Necrosis of bowel wall secondary to polymicrobial invasion
	**Involves terminal ileum and colon		**Involves terminal ileum and colon

ClaireLewis: /* References */

2019-10-29T21:51:25Z

References

← Revisión anterior		Revisión del 21:51 29 oct 2019
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	[[Category:ID]]		[[Category:ID]]
	[[category:Surgery]]		[[category:Surgery]]
			[[Category:Heme/Onc]]

ClaireLewis at 23:13, 29 September 2019

2019-09-29T23:13:17Z

← Revisión anterior		Revisión del 23:13 29 sep 2019
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	**Involves terminal ileum and colon		**Involves terminal ileum and colon
	**May progress to full-thickness infarction/perforation		**May progress to full-thickness infarction/perforation
	*Occurs 10-14d after cytotoxic therapy

	==Clinical Features==		==Clinical Features==
	*Fever		*Typically presents 10-14d after cytotoxic therapy
	*RLQ pain		*[[neutropenic fever\|Fever]]
	*Nausea		*[[RLQ pain]]
	*Vomiting		*[[Nausea/vomiting]]

	==Differential Diagnosis==		==Differential Diagnosis==
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	==Evaluation==		==Evaluation==
	===Workup<ref>Machado NO. Neutropenic enterocolitis: A continuing medical and surgical challenge. N Am J Med Sci. 2010 Jul; 2(7): 293–300.</ref>===		===Workup<ref>Machado NO. Neutropenic enterocolitis: A continuing medical and surgical challenge. N Am J Med Sci. 2010 Jul; 2(7): 293–300.</ref>===
	*CBC with neutropenia, thrombocytopenia		*CBC with [[neutropenia]], [[thrombocytopenia]]
	*Blood cultures positive in ~25-85%, frequently bowel organisms		*Blood cultures positive in ~25-85%, frequently bowel organisms
	*CT A/P: cecal distention, wall thickening, pneumatosis intestinalis, intestinal perforation, fat stranding		*CT A/P: cecal distention, wall thickening, pneumatosis intestinalis, intestinal perforation, fat stranding
Línea 24:		Línea 23:
	==Management==		==Management==
	*Bowel rest		*Bowel rest
	*NG tube to suction		*[[NG tube]] to suction
	*IVF		*[[IVF]]
	*TPN		*TPN
	*Consider G-CSF, particularly neutropenia < 100/ml and severe disease<ref>Greil R, Psenak O, Roila F. ESMO Guidelines Working Group. Hematopoietic growth factors: ESMO recommendations for the applications. Ann Oncol. 2008;19(suppl 2:ii):116–1118.</ref>		*Consider G-CSF, particularly neutropenia < 100/ml and severe disease<ref>Greil R, Psenak O, Roila F. ESMO Guidelines Working Group. Hematopoietic growth factors: ESMO recommendations for the applications. Ann Oncol. 2008;19(suppl 2:ii):116–1118.</ref>
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	[[Category:GI]]		[[Category:GI]]
	[[Category:ID]]		[[Category:ID]]
			[[category:Surgery]]

Mholtz at 23:10, 11 February 2017

2017-02-11T23:10:57Z

← Revisión anterior		Revisión del 23:10 11 feb 2017
Línea 23:		Línea 23:

	==Management==		==Management==
	#Bowel rest		*Bowel rest
	#NG suction		*NG tube to suction
	#IVF		*IVF
	#TPN		*TPN
	#Consider G-CSF, particularly neutropenia < 100/ml and severe disease<ref>Greil R, Psenak O, Roila F. ESMO Guidelines Working Group. Hematopoietic growth factors: ESMO recommendations for the applications. Ann Oncol. 2008;19(suppl 2:ii):116–1118.</ref>		*Consider G-CSF, particularly neutropenia < 100/ml and severe disease<ref>Greil R, Psenak O, Roila F. ESMO Guidelines Working Group. Hematopoietic growth factors: ESMO recommendations for the applications. Ann Oncol. 2008;19(suppl 2:ii):116–1118.</ref>
	#Broad spectrum antimicrobials, in particular against gut microbiota to include<ref>Gorschluter M, Mey U, Strehl J, Zinske C, Schepke M, Schmid F, Wolf IG, Sauerbruch T, Glasmacher A, et al. Neutropenic enterocolitis in adults: systematic analysis of evidence quality. Eur J Haematol. 2005;75(1):1–13.</ref>:		*Broad spectrum antimicrobials, in particular against gut microbiota to include<ref>Gorschluter M, Mey U, Strehl J, Zinske C, Schepke M, Schmid F, Wolf IG, Sauerbruch T, Glasmacher A, et al. Neutropenic enterocolitis in adults: systematic analysis of evidence quality. Eur J Haematol. 2005;75(1):1–13.</ref>:
	#*[[Metronidazole]] plus [[cefepime]]		**[[Metronidazole]] plus [[cefepime]]
	#*[[Piperacillin-tazobactam]]		**[[Piperacillin-tazobactam]]
	#*[[Amphotericin B]] when patient remains febrile, neutropenic for greater than 5 days despite broad spectrum antibiotics		**[[Amphotericin B]] when patient remains febrile, neutropenic for greater than 5 days despite broad spectrum antibiotics
	~~#Consider surgical~~ consult~~, in particular~~ for right hemicolectomy<ref>Williams N, Scott AD. Neutropaenic enterocolitis : a continuing surgical challenge. Br J Surg. 1997;84(9):1200–1205.</ref>		*Surgical consult (possible need for right hemicolectomy)<ref>Williams N, Scott AD. Neutropaenic enterocolitis : a continuing surgical challenge. Br J Surg. 1997;84(9):1200–1205.</ref>

	==Disposition==		==Disposition==
	*~~Surgial consult (possible right hemicolectomy)~~		*Admit

	==See Also==		==See Also==
	*[[Neutropenic fever]]		*[[Neutropenic fever]]
	==~~Sources~~==
			==References==
	<references/>		<references/>

	[[Category:GI]]		[[Category:GI]]
	[[Category:ID]]		[[Category:ID]]

Kxl328 at 11:49, 11 February 2017

2017-02-11T11:49:06Z

← Revisión anterior		Revisión del 11:49 11 feb 2017
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	#Broad spectrum antimicrobials, in particular against gut microbiota to include<ref>Gorschluter M, Mey U, Strehl J, Zinske C, Schepke M, Schmid F, Wolf IG, Sauerbruch T, Glasmacher A, et al. Neutropenic enterocolitis in adults: systematic analysis of evidence quality. Eur J Haematol. 2005;75(1):1–13.</ref>:		#Broad spectrum antimicrobials, in particular against gut microbiota to include<ref>Gorschluter M, Mey U, Strehl J, Zinske C, Schepke M, Schmid F, Wolf IG, Sauerbruch T, Glasmacher A, et al. Neutropenic enterocolitis in adults: systematic analysis of evidence quality. Eur J Haematol. 2005;75(1):1–13.</ref>:
	#*[[Metronidazole]] plus [[cefepime]]		#*[[Metronidazole]] plus [[cefepime]]
	#*[[Piperacillin-~~tazobactum~~]]		#*[[Piperacillin-tazobactam]]
	#*[[Amphotericin B]] when patient remains febrile, neutropenic for greater than 5 days despite broad spectrum antibiotics		#*[[Amphotericin B]] when patient remains febrile, neutropenic for greater than 5 days despite broad spectrum antibiotics
	#Consider surgical consult, in particular for right hemicolectomy<ref>Williams N, Scott AD. Neutropaenic enterocolitis : a continuing surgical challenge. Br J Surg. 1997;84(9):1200–1205.</ref>		#Consider surgical consult, in particular for right hemicolectomy<ref>Williams N, Scott AD. Neutropaenic enterocolitis : a continuing surgical challenge. Br J Surg. 1997;84(9):1200–1205.</ref>

Kxl328 at 11:48, 11 February 2017

2017-02-11T11:48:52Z

← Revisión anterior		Revisión del 11:48 11 feb 2017
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	#NG suction		#NG suction
	#IVF		#IVF
	#Broad ~~spec~~ antibiotics		#TPN
			#Consider G-CSF, particularly neutropenia < 100/ml and severe disease<ref>Greil R, Psenak O, Roila F. ESMO Guidelines Working Group. Hematopoietic growth factors: ESMO recommendations for the applications. Ann Oncol. 2008;19(suppl 2:ii):116–1118.</ref>
			#Broad spectrum antimicrobials, in particular against gut microbiota to include<ref>Gorschluter M, Mey U, Strehl J, Zinske C, Schepke M, Schmid F, Wolf IG, Sauerbruch T, Glasmacher A, et al. Neutropenic enterocolitis in adults: systematic analysis of evidence quality. Eur J Haematol. 2005;75(1):1–13.</ref>:
			#*[[Metronidazole]] plus [[cefepime]]
			#*[[Piperacillin-tazobactum]]
			#*[[Amphotericin B]] when patient remains febrile, neutropenic for greater than 5 days despite broad spectrum antibiotics
			#Consider surgical consult, in particular for right hemicolectomy<ref>Williams N, Scott AD. Neutropaenic enterocolitis : a continuing surgical challenge. Br J Surg. 1997;84(9):1200–1205.</ref>

	==Disposition==		==Disposition==

Kxl328 at 11:40, 11 February 2017

2017-02-11T11:40:53Z

← Revisión anterior		Revisión del 11:40 11 feb 2017
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	==See Also==		==See Also==
	*[[Neutropenic fever]]		*[[Neutropenic fever]]
			==Sources==
			<references/>
	[[Category:GI]]		[[Category:GI]]
	[[Category:ID]]		[[Category:ID]]