A CASE PRESENTATION AND REVIEW OF NEUTROPENIC ENTEROCOLITIS

Neutropenic enterocolitis (NE) is an unusual complication of neutropen ia. Its presentation is dramatic, treatment is controversial, and the outcome may be devastating. The available literature about this entity is mainly case reports and autopsy studies. We have recently performe d a celiotomy on a patient who developed sepsis and an acute surgical abdomen three days following chemotherapy and radiotherapy for a metas tatic adenocarcinoma with no known primary tumor. At surgery he was fo und to have a boggy right and recto-sigmoid colon with a grossly norma l transverse colon. Intraoperative colonoscopy revealed mucosal ulcera tion and necrosis extending from the dentate line to the cecum. A tota l abdominal colectomy, closure of the rectal stump, and an ileostomy w as performed. Postoperatively, the patient recovered from the abdomina l septic process only to succumb to multiple system organ failure seco ndary to pulmonary sepsis. Upon review of the literature, we found 65 cases of NE that were suspected or diagnosed in the antemortem state a nd confirmed at surgery or autopsy. In this review, we intend to analy ze these case reports, summarize the salient features of the disease a nd outline the optimal therapeutic approach.