Typhlitis in acute childhood leukaemia: radiological features

Typhlitis is a necrotising inflammation of the caecum usually found in acute leukaemic patients on chemotherapy. We described the radiological features of two children with this complication. The first was diagnosed by an enema using water-soluble contrast medium and the second by ultrasound and computed tomography (CT). A water-soluble contrast medium enema is considered diagnostic in this clinical context and excludes intussusception and, often, appendicitis. Ultrasound showed a rounded mass with dense central echoes and a wider hypoechoic periphery. Computed tomography showed the long segment of thick-walled ascending colon and caecum; if perforation is suspected, ultrasound and CT might be preferable to a contrast enema.