Neutropenic enterocolitis as a surgical urgency. A case report

DOI 10.17605/OSF.IO/T2N3P

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Adame Palacios OU, Evaristo Mendez G, Prieto Ramos RC, Garcia Bravo LM, Posadas Estrada DS, Oropeza Duarte C, Navarro Nuño DE, Escobar Conejo G. Neutropenic enterocolitis as a surgical urgency. A case report. Am J Med Surg • February 2022; 7(1). 5-8

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Neutropenic enterocolitis was first described in pediatric patients, but later also in adults with hematologic malignancies or solid tumors. This entity can evolve, during the stage of maximum neutropenia due to chemotherapy, to intestinal perforation. We present the case of an adult patient with neutropenic enterocolitis whose first clinical manifestation was an acute abdomen. Case report: A 19-year-old man with acute lymphoblastic leukemia received several cycles of chemotherapy before developing abdominal pain, hematochezia, fever, and evidence of peritoneal irritation. Laboratory studies showed platelets 7.7 x 103 / μL, leukocytes 0.03 x 103 / μL, and absolute neutrophil count of 0.001 x 103 / μL. The computed tomography scan showed a thickening of the wall of the ascending colon. Exploratory laparotomy with right hemicolectomy, terminal ileostomy and mucous fistula of the transverse colon was performed due to the presence of an inflammatory mass in the entire ascending colon. The final pathological diagnosis was neutropenic enterocolitis. Conclusion: The increased use of chemotherapy and immunosuppressive drugs is expected to increase the prevalence and incidence of neutropenic enterocolitis, which can present as a surgical emergency.

 

Key words: Neutropenic enterocolitis. Acute abdomen. Hemicolectomy.