Colon non tumor
Colitis (non-infectious)
Typhlitis

Author: Hanni Gulwani, M.D. (see Authors page)

Revised: 27 December 2016, last major update May 2013

Copyright: (c) 2003-2016, PathologyOutlines.com, Inc.

PubMed Search: Typhlitis
Cite this page: Typhlitis. PathologyOutlines.com website. http://pathologyoutlines.com/topic/colontyphlitis.html. Accessed February 22nd, 2017.
Definition / General
  • Means inflammation of cecum (eMedicine); a 19th century term for severe acute/chronic inflammation of cecum/appendix, probably due to untreated acute appendicitis
  • Currently, represents a life threatening acute inflammatory destruction of cecal mucosa in neutropenic patients, possibly due to impaired mucosal immunity and compromised blood flow; also associated with secondary bacteria and fungal overgrowth but minimal active inflammation (due to neutropenia)
  • Also called hemorrhagic necrosis of bowel wall, neutropenic colitis
  • Often leukemia or lymphoma patients after immunosuppressive therapy
  • Mechanism (not known), but probably due to a combination of ischemia, infection (especially with cytomegalovirus), mucosal hemorrhage, and perhaps neoplasia
Clinical Features
  • Present with fever, watery or bloody diarrhea, and abdominal pain, may be localized in right lower quadrant (Radiographics 2000;20:399)
  • May cause perforation and require surgery
  • Severity in childhood cancer is related to duration of neutropenia and presence of fever or abdominal tenderness (Cancer 2005;104:380)
Diagnosis
  • Usually diagnosed by CT scan due to thickening of cecal wall
Prognostic Factors
Case Reports
Gross Description
  • Inflamed cecum and proximal right colon with hemorrhage and mucosal edema
Micro Description
  • Adherent fibrinopurulent exudate over necrotic and edematous mucosa
Micro Images

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Colonic stenosis in neutropenic patient