GASTROENTEROLOGY ARTICLE OF THE WEEK
April 20, 2000
Urbach D, Rotstein OD. Typhlitis. CJS 1999;42:415-419.
1. Pathological characteristics of typhlitis include
a. involvement of the terminal ileum and cecum
b. mucosal edema or edema of the entire intestinal wall
c. acute inflammatory infiltrates are common
d. lack of normal granulocytic
reaction to infection
2. Regarding the diagnosis and evaluation of suspected typhlitis
a. fever and bacteremia are common
b. barium enema is useful in establishing the diagnosis
c. pneumatosis of the cecum may be present
d. colonoscopy is the preferred
diagnostic test
3. Indications for surgery in typhlitis include
a. gastrointestinal bleeding despite correction of neutropenia
b. positive blood cultures
c. perforation
d. clinical deterioration despite medical therapy
e. uncertain diagnosis
4. Glutamine is an
essential amino acid that is important in maintaining gut integrity.
5. Typhlitis typically
occurs during the first 3 days of chemotherapy administration
6. Normal neutrophil
counts excludes the diagnosis
7. The next step in the
evaluation of a patient with suspected typhlitis, non-diagnostic plain X-rays and no
indication for emergency laparotomy is colonoscopy.