Neutropenic typhlitis. A plea for conservatism

Neutropenic typhlitis is an acute inflammation of the cecum occurring in neutropenic patients. Two cases are described, both presenting typical features of the disease. It is our experience that the treatment approach should consist of bowel rest, fluid therapy, and massive administration of broad spectrum antibiotics. In some cases, full recovery will follow. If abdominal signs persist, surgery should be deferred until hematologic convalescence occurs. At this time, cecostomy and drainage should be adequate. Only in very severe cases, with wide-spread necrosis, should a right hemicolectomy be performed.