CT features of neutropenic enterocolitis in adult patients with hematological diseases undergoing chemotherapy.

Purpose: This study investigates the features of neutropenic enterocolitis (NE) in adults.
Materials and Methods: Chart and radiology report reviews were used to identify neutropenic patients with hematological diseases undergoing chemotherapy, who had CT scans for the clarification of abdominal symptoms between October 2003 and October 2009. Patients with any cause for enteritis other than NE were excluded. The scans were analyzed with respect to imaging features and location. Morphological findings were correlated with clinical data.
Results: Thirty-one patients with NE (median age 46 years; range 20 - 75) could be identified. Wall thickening and hyperemia could be found in all bowel segments from jejunum to rectum. The right hemicolon was the most frequent location in 19 patients (61%). Involvement was generalized in 6 patients (19%) and segmental in 25 cases (81%). The longer the duration of neutropenia, the more likely generalized involvement of the bowel was. In 8 patients who underwent CT follow-up, the appearance of bowel segments had completely (n = 5) or partially (n = 3) returned to normal at the latest 14 days after the initial diagnosis. Eight patients (26%) died 1 - 78 days after NE, 7 of who had previously recovered from NE.
Conclusion: CT findings are useful for the diagnosis of NE and should be considered even in the presence of isolated small bowel involvement. The terms NE and typhlitis should thus no longer be used synonymously.
(© Georg Thieme Verlag KG Stuttgart · New York.)