Vogel M N, Goeppert B, Maksimovic O, Brodoefel H, Faul C, Claussen C D, Horger M
Department of Diagnostic and Interventional Radiology, Eberhard-Karls-Universität, Tübingen.
Rofo. 2010 Dec;182(12):1076-81. doi: 10.1055/s-0029-1245815. Epub 2010 Nov 12.
This study investigates the features of neutropenic enterocolitis (NE) in adults.
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.
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.
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.
本研究调查成人中性粒细胞减少性小肠结肠炎（NE）的特征。
通过查阅病历和放射学报告，识别2003年10月至2009年10月期间接受化疗的血液系统疾病中性粒细胞减少患者，这些患者因腹部症状行CT扫描以明确病因。排除除NE以外任何病因引起的肠炎患者。对扫描结果进行成像特征和部位分析。形态学表现与临床资料相关联。
共识别出31例NE患者（中位年龄46岁；范围20 - 75岁）。从空肠到直肠的所有肠段均可见肠壁增厚和充血。右半结肠是最常见的受累部位，19例患者（61%）出现该情况。6例患者（19%）为全肠道受累，25例患者（81%）为节段性受累。中性粒细胞减少持续时间越长，肠道全层受累的可能性越大。8例接受CT随访的患者中，肠段表现最晚在初始诊断后14天完全（n = 5）或部分（n = 3）恢复正常。8例患者（26%）在NE发生后1 - 78天死亡，其中7例之前已从NE中恢复。
CT表现对NE的诊断有用，即使仅存在小肠受累时也应考虑。因此，NE和盲肠炎不应再被视为同义词。
