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Typhlitis. An 18-year experience and postmortem review.

J A Katz¹, M L Wagner, M V Gresik

¹Department of Pediatrics, Texas Children's Hospital, Houston 77030.

|February 15, 1990

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Typhlitis, an inflammation of the colon, occurred in 24% of acute leukemia patients. This review details its clinical and autopsy findings, emphasizing its association with chemotherapy and myelosuppression in children.

Area of Science:

Pediatric Pathology
Gastroenterology
Hematology Oncology

Background:

Typhlitis, also known as neutropenic enterocolitis, is a serious complication in immunocompromised patients.
It is frequently observed in children undergoing chemotherapy for hematologic malignancies.
Understanding its incidence, clinical presentation, and pathological features is crucial for timely diagnosis and management.

Purpose of the Study:

To review pediatric autopsy cases of typhlitis.
To identify the incidence and clinical features of typhlitis in patients with acute leukemia, lymphoblastic lymphoma, and aplastic anemia.
To describe the anatomical distribution and associated factors of typhlitis.

Main Methods:

Retrospective review of pediatric autopsy results from Texas Children's Hospital (1970-1987).

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Identification of cases with typhlitis, correlating with underlying diagnoses, clinical symptoms, and treatment history.

Analysis of postmortem findings, including anatomical extent and associated infections.

Main Results:

Thirty-three cases of typhlitis were identified in patients with acute leukemia, with a postmortem incidence of 24%.
Common symptoms included abdominal pain (78%) and lower gastrointestinal bleeding (35%).
Radiographic findings ranged from nonspecific bowel gas patterns to pneumatosis intestinalis. Fungal pathogens were significant postmortem findings.

Conclusions:

Typhlitis is a significant postmortem finding in pediatric patients with acute leukemia, often associated with chemotherapy and myelosuppression.
Clinical and radiographic findings can be variable, highlighting the importance of autopsy in confirming the diagnosis.
Further research into diagnostic and management strategies is warranted.