Neutropenic enterocolitis in adults : Case series and review of the literature

Necrotizing enterocolitis in adults is a rare disease and, in the past, has been associated with nearly uniform mortality. In recent years, necrotizing enterocolitis, now termed neutropenic enterocolitis, in adults has become more prevalent as a complication of aggressive systemic chemotherapy. In t...

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Published in:Digestive diseases and sciences 2005-02, Vol.50 (2), p.215-220
Main Authors: CUNNINGHAM, Steven C, FAKHRY, Karim, BASS, Barbara L, NAPOLITANO, Lena M
Format: Article
Language:English
Subjects:
Aged
Antineoplastic Agents - adverse effects
Antineoplastic Agents - therapeutic use
Biological and medical sciences
Carcinoma, Small Cell - drug therapy
Enterocolitis, Neutropenic - chemically induced
Enterocolitis, Neutropenic - pathology
Enterocolitis, Neutropenic - surgery
Gastroenterology. Liver. Pancreas. Abdomen
Hematologic and hematopoietic diseases
Humans
Intestine, Small - pathology
Leukemia, Erythroblastic, Acute - drug therapy
Lung Neoplasms - drug therapy
Male
Medical sciences
Middle Aged
Other diseases. Hematologic involvement in other diseases
Other diseases. Semiology
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
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Summary:Necrotizing enterocolitis in adults is a rare disease and, in the past, has been associated with nearly uniform mortality. In recent years, necrotizing enterocolitis, now termed neutropenic enterocolitis, in adults has become more prevalent as a complication of aggressive systemic chemotherapy. In this report, we discuss two cases of neutropenic enterocolitis secondary to the administration of systemic chemotherapy in adult cancer patients: one with lung carcinoma, the other with leukemia. Both patients were successfully treated with early surgical intervention for resection of all necrotizing enteric lesions, and subsequent aggressive critical care support. Our experience suggests that early surgical intervention in adult patients with intestinal necrosis due to chemotherapy is essential to avoid mortality from this condition. Given the widespread, aggressive use of systemic chemotherapy in the neoadjuvant setting, patients at risk for this potentially lethal complication of neutropenic enterocolitis are increasingly common.
ISSN:0163-2116
1573-2568
DOI:10.1007/s10620-005-1585-1