Neutropenic enterocolitis: a serious complication during the treatment of acute leukemias.
Neutropenic enterocolitis (NE) is a severe gastrointestinal complication in patients who undergo aggressive chemotherapy. It is a necrotizing inflammation of the cecum, colon, and the terminal part of the ileum. The serious clinical state of NE patients requires very frequent surgical consultations; however, in a few particular cases of NE, e.g., perforation of the bowels, a surgical intervention is necessary. Here, we report on six cases of NE in patients with acute leukemias. The patients were all women aged 21-55 years. Two of them had acute myeloid leukemia and four had lymphoblastic leukemia. NE occurred 7-10 days after the completion of chemotherapy, during the neutropenic phase. They represented a typical picture of NE: two of them died because of septic shock; five patients had subileus with irritation of the peritoneum; and one had hepatosplenic abscesses confirmed 6 months later by post-mortem examination. In each case, a surgical opinion was required. None of these patients were operated on. We present a report summarizing our experience and problems with six patients who had a clinical picture of NE and offer a short review of the current literature on the subject.
Wach
Malgorzata
M
Department of Haematooncology and Bone Marrow Transplantation, University School of Medicine, Jaczewskiego 8 Stv., Lublin, Poland. mijwach@poczta.onet.pl
Dmoszynska
Anna
A
Wasik-Szczepanek
Ewa
E
Pozarowski
Andrzej
A
Drop
Andrzej
A
Szczepanek
Dariusz
D
D000008:Abdominal Neoplasms; D000208:Acute Disease; D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects; D044504:Enterocolitis, Neutropenic / Q000139:chemically induced*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007938:Leukemia / Q000150:complications* / Q000188:drug therapy; D007945:Leukemia, Lymphoid / Q000150:complications / Q000188:drug therapy; D007951:Leukemia, Myeloid / Q000150:complications / Q000188:drug therapy; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced; D012017:Referral and Consultation; D013921:Thrombocytopenia / Q000139:chemically induced; D016896:Treatment Outcome
D000970:Antineoplastic Agents