title: Neutropenic enterocolitis affecting the transverse colon: an unusual complication of chemotherapy.
abstract: A 66-year-old woman presented with a 1-day history of sudden onset of generalised abdominal pain associated with fever and vomiting. She was previously diagnosed with left breast cancer 2 months ago and completed a course of chemotherapy 1 week prior to presentation. She was clinically unwell with generalised tenderness in her abdomen. Blood investigations showed severe neutropenia. A CT scan was requested which reported a marked oedematous swelling of the transverse colon with features suggestive of a contained perforation. The decision was made to operate. Intraoperatively, the transverse colon was found to be thickened with omentum adherent focally around the distal third. A right hemicolectomy was performed with an end ileostomy and mucus fistula. The patient made a successful recovery and was discharged within 7 days of presenting. Pathology reported typical features of neutropenic enterocolitis affecting the transverse colon with a normal terminal ileum, caecum and ascending colon.
authors.affiliation: Inverclyde Royal Hospital, Greenock, UK.
authors.forename: Jason
authors.initials: J
authors.lastname: Ramsingh
authors.forename: Carsten
authors.initials: C
authors.lastname: Bolln
authors.forename: Robert
authors.initials: R
authors.lastname: Hodnett
authors.forename: Ahmed
authors.initials: A
authors.lastname: Al-Ani
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy*; D003082:Colectomy; D044684:Colon, Transverse; D003520:Cyclophosphamide / Q000008:administration & dosage; D000077143:Docetaxel; D044504:Enterocolitis, Neutropenic / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D007081:Ileostomy; D043823:Taxoids / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed
chemical_list: D043823:Taxoids; D000077143:Docetaxel; D003520:Cyclophosphamide