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Typhlitis with clinical presentation mimicking appendicitis

Department of Radiology, Mackay Memorial Hospital, Taipei, Taiwan

Correspondence to:
Correspondence to:
Dr Chin-Yin Sheu
Department of Radiology, Mackay Memorial Hospital, 92, Section 2, Chungshan North Road, Taipei, Taiwan; kuorichardkuo@yahoo.com.tw

Accepted 30 August 2006

The first 150 words of the full text of this article appear below.

A 62-year-old woman presented with diffuse persistent low abdominal pain with fever (38.8°C). She had acute myelogenous leukaemia and had received her first course of consolidation chemotherapy 1 week previously. The physical examination found severe right lower quadrant tenderness with rebounding pain. Blood analysis revealed a white blood cell count 200x10⁶/l. Abdominal computed tomographic (CT) scan revealed circumferential wall thickening of the caecum and terminal ileum (fig 1). The CT findings under this clinical setting were consistent with typhlitis. Broad spectrum antibiotics were administered and the symptoms gradually dissipated within a few days. Typhlitis—also called neutropenic enterocolitis—is characterised by inflammation of the caecum and terminal ileum as a result of bowel wall invasion by intestinal organisms due to impaired host defences. The clinical presentation of typhlitis is similar to appendicitis, but in most patients symptoms resolve after correction of the neutropenia and conservative treatment with bowel . . . [Full text of this article]