Cunningham Steven C, Fakhry Karim, Bass Barbara L, Napolitano Lena M
Department of Surgery, Baltimore VA Medical Center, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Dig Dis Sci. 2005 Feb;50(2):215-20. doi: 10.1007/s10620-005-1585-1.
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.
成人坏死性小肠结肠炎是一种罕见疾病,过去几乎与一致的死亡率相关。近年来,成人坏死性小肠结肠炎(现称为中性粒细胞减少性小肠结肠炎)作为积极全身化疗的并发症变得更为普遍。在本报告中,我们讨论了两例成年癌症患者因全身化疗继发中性粒细胞减少性小肠结肠炎的病例:一例为肺癌患者,另一例为白血病患者。两名患者均通过早期手术干预成功治疗,切除所有坏死性肠道病变,并随后接受积极的重症监护支持。我们的经验表明,对于因化疗导致肠道坏死的成年患者,早期手术干预对于避免该疾病导致的死亡至关重要。鉴于全身化疗在新辅助治疗中广泛、积极地应用,面临这种潜在致命并发症——中性粒细胞减少性小肠结肠炎风险的患者越来越常见。