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Neutropenic colitis with cecal perforation during antithyroid therapy
Der-Fang Chen1, Ing-Ming Chao, Shi-Hsin Huang
1Division of General Surgery, Department of Surgery, Cathay General Hospital, Taipei, Taiwan.
Journal of the Formosan Medical Association = Taiwan Yi Zhi
|November 20, 2003
Summary
Neutropenic colitis, a rare complication of chemotherapy or medications like methimazole, can cause severe bowel inflammation and perforation. Early detection in neutropenic patients is crucial to prevent mortality.
Area of Science:
- Gastroenterology
- Internal Medicine
- Pharmacology
Background:
- Neutropenic colitis is an inflammation of the colon associated with neutropenia.
- It is a rare but serious complication often seen in patients undergoing chemotherapy for hematological malignancies.
- It can also occur with medications, such as methimazole used for hyperthyroidism.
Observation:
- A case of neutropenic colitis with cecal perforation is presented in a 44-year-old woman treated with methimazole for hyperthyroidism.
- The patient presented with fever, diarrhea, weakness, and abdominal pain, leading to the discovery of peritonitis and neutropenia.
- Emergent laparotomy revealed chronic cecal ulceration and perforation.
Findings:
- Surgical intervention included resection of the ileocecal segment and ileostomy, followed by ileocolostomy closure.
- The patient remained stable during a 9-year follow-up period.
- This case highlights the potential for severe gastrointestinal complications, including perforation, from neutropenic enterocolitis.
Implications:
- Neutropenic enterocolitis presents with diverse clinical signs, necessitating vigilance in neutropenic patients.
- Delayed diagnosis and treatment can lead to critical outcomes like bowel perforation and death.
- Awareness of this condition is vital for timely intervention and improved patient prognosis.