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Typhlitis: selective surgical management.

C R Moir, C H Scudamore, W B Benny

    American Journal of Surgery
    |May 1, 1986
    PubMed
    Summary
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    Typhlitis, a serious neutropenic enterocolitis, is increasingly seen in leukemia patients. Early diagnosis and management, including bowel rest and antibiotics, are crucial for preventing complications and improving outcomes.

    Area of Science:

    • Gastroenterology
    • Hematology
    • Oncology

    Background:

    • Typhlitis, or neutropenic enterocolitis, is a severe gastrointestinal complication.
    • Its incidence is rising, particularly in acute myelogenous leukemia patients receiving high-dose chemotherapy.
    • Symptoms include fever, diarrhea, and abdominal pain during neutropenia.

    Purpose of the Study:

    • To review the diagnosis and management of typhlitis.
    • To emphasize the importance of early recognition and intervention.
    • To highlight strategies for reducing complications in immunocompromised patients.

    Main Methods:

    • Diagnosis confirmed by clinical examination and imaging (radiographs, ultrasound, CT, scans).
    • Management includes bowel rest, nasogastric suction, total parenteral nutrition, and broad-spectrum antibiotics.

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  • Surgical intervention is reserved for complications like perforation, obstruction, or abscess.

    • Main Results:

    • Nonoperative management with bowel rest and TPN is effective for many patients.
    • Surgical resection (e.g., right hemicolectomy) is necessary for severe, unresponsive cases.
    • A combined approach reduced typhlitis complications in acute myeloblastic leukemia patients.

    Conclusions:

    • Timely diagnosis and management of typhlitis are critical for patient survival.
    • Prophylactic measures are recommended for patients with a history of gastrointestinal issues.
    • Preventing complications through early intervention significantly improves outcomes.