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Int J Colorectal Dis. 2003 Sep;18(5):455-8. Epub 2003 May 16.

Neutropenic enterocolitis: is it possible to break vicious circle between neutropenia and the bowel wall inflammation by surgery?

Author information

  • 1Department of Pediatric Surgery, School of Medicine, Osmangazi University, 26480 Eskisehir, Turkey. btokar@ogu.edu.tr

Abstract

BACKGROUND:

Neutropenic enterocolitis is a devastating bowel wall inflammation in patients with protracted neutropenia. The approach for diagnosis and treatment is still controversial, and it is difficult and challenging to decide on what should be the next step in the management.

CASE PRESENTATION:

We report a 10-year-old boy who developed neutropenic enterocolitis in the course of the conservative treatment for aplastic anemia. Oral mucositis and the perianal fissure with an ulcer were important indicators for what was happening on the colonic mucosa. Colonoscopy and biopsy confirmed the diagnosis. A fast recovery was achieved with a right hemicolectomy and ileostomy.

CONCLUSION:

Retrospective analysis of the long-term follow-up of our patient suggests that defunctioning the colon by ileostomy breaks the vicious circle between neutropenia and bowel wall inflammation, and an early surgical intervention could be considered as an adjunctive approach to the conservative management of persistent cases.

PMID:
12750931
[PubMed - indexed for MEDLINE]
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