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


METHODS
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.


CONCLUSIONS
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.
Department of Pediatric Surgery, School of Medicine, Osmangazi University, 26480 Eskisehir, Turkey. btokar@ogu.edu.tr
Baran
B
Tokar
Sultan
S
Aydoğdu
Ozgül
O
Paşaoğlu
Huseyin
H
Ilhan
Emine
E
Kasapoğlu
D000741:Anemia, Aplastic / Q000150:complications; D002648:Child; D003082:Colectomy / Q000379:methods*; D044504:Enterocolitis, Neutropenic / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007081:Ileostomy / Q000379:methods*; D008297:Male; D016896:Treatment Outcome