Early Diagnosis of Neutropenic Enterocolitis by Ultrasound Sonography.

Edoardo Benedetti, Hematologist*,1, Federico Simonetti, MD*,1, Francesco Caracciolo*,1, Federico Papineschi*,1, Benedetto Bruno, MD, PhD*,2, Matteo Pelosini*,3, Daniele Focosi, M.D.*,4, Sara Galimberti*,5 and Mario Petrini, MD6

Author address: 

1 Division of Haematology - Department of Oncology, Transplants and Advances in Medicine, University of Pisa, Pisa, Italy, 2 University of Torino, Torino, Italy, 3 Hem/Onc., MD Anderson Cancer Ctr., Houston, TX, USA, 4 Division of Hematology, D


Introduction: Neutropenic enterocolitis (NEC) is a life threatening complication of chemotherapy in leukemic and solid tumor patients with an incidence ranging from 2.6% to 33%. It is a necrotizing inflammatory disease that most commonly involves the ileo-cecal region. The cecum is almost invariably affected likely due to its distensibility and limited blood supply. Macroscopically the involved bowel segments show oedematous and thickened walls, with varying degrees of ulceration and haemorrhage. Perforation occurs in 5%-10% of cases. Early diagnosis is crucial to start conservative medical treatment which appears the optimal strategy. Criteria for prompt surgical treatment have also been proposed (Shamberger RC et al, 1986) so that a careful clinical evaluation by both the physician and the surgeon is mandatory (Davila ML et al, 2004). NEC should be always suspected in neutropenic patients with abdominal pain, fever and diarrhea. Ultrasound (US) has been used to evaluate bowel-wall thickening (BWT). One study correlated BWT with clinical outcome: 60% of patients with BWT > 10 mm died from NEC as compared with 4.2% of those with BWT

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Full conference title: 

51st American Society of Haematologists Annual Meeting
    • ASH 51st (2009)