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Case Reports
. 2014 May 2:2014:bcr2014204035.
doi: 10.1136/bcr-2014-204035.

Neutropenic enterocolitis affecting the transverse colon: an unusual complication of chemotherapy

Jason Ramsingh  1 , Carsten Bolln, Robert Hodnett, Ahmed Al-Ani
Affiliations
Case Reports

Neutropenic enterocolitis affecting the transverse colon: an unusual complication of chemotherapy

Jason Ramsingh et al. BMJ Case Rep. .

Abstract

A 66-year-old woman presented with a 1-day history of sudden onset of generalised abdominal pain associated with fever and vomiting. She was previously diagnosed with left breast cancer 2 months ago and completed a course of chemotherapy 1 week prior to presentation. She was clinically unwell with generalised tenderness in her abdomen. Blood investigations showed severe neutropenia. A CT scan was requested which reported a marked oedematous swelling of the transverse colon with features suggestive of a contained perforation. The decision was made to operate. Intraoperatively, the transverse colon was found to be thickened with omentum adherent focally around the distal third. A right hemicolectomy was performed with an end ileostomy and mucus fistula. The patient made a successful recovery and was discharged within 7 days of presenting. Pathology reported typical features of neutropenic enterocolitis affecting the transverse colon with a normal terminal ileum, caecum and ascending colon.

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Figures

Figure 1
Figure 1
Coronal section illustrating markedly oedematous transverse colon with contained perforation.
See this image and copyright information in PMC

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