Neutropenic enterocolitis affecting the transverse colon: an unusual complication of chemotherapy.

Abstract

A 66-year-old woman presented with a 1-day history of sudden onset of generalised abdominal pain associated with fever and vomiting. She was previously diagnosed with left breast cancer 2 months ago and completed a course of chemotherapy 1 week prior to presentation. She was clinically unwell with generalised tenderness in her abdomen. Blood investigations showed severe neutropenia. A CT scan was requested which reported a marked oedematous swelling of the transverse colon with features suggestive of a contained perforation. The decision was made to operate. Intraoperatively, the transverse colon was found to be thickened with omentum adherent focally around the distal third. A right hemicolectomy was performed with an end ileostomy and mucus fistula. The patient made a successful recovery and was discharged within 7 days of presenting. Pathology reported typical features of neutropenic enterocolitis affecting the transverse colon with a normal terminal ileum, caecum and ascending colon.

• Authors: Jason Ramsingh, Carsten Bolln, Robert Hodnett, Ahmed Al-Ani
• Journal: BMJ case reports (BMJ Case Rep) Vol. 2014 (May 02 2014) ISSN: 1757-790X [Electronic] England
• PMID: 24792023 (Publication Type: Case Reports, Journal Article)

Chemical References

• Taxoids
• Docetaxel
• Cyclophosphamide

Topics

• Aged
• Antineoplastic Combined Chemotherapy Protocols (adverse effects)
• Breast Neoplasms (drug therapy)
• Colectomy
• Colon, Transverse
• Cyclophosphamide (administration & dosage)
• Docetaxel
• Enterocolitis, Neutropenic (chemically induced, diagnostic imaging, surgery)
• Female
• Humans
• Ileostomy
• Taxoids (administration & dosage)
• Tomography, X-Ray Computed