Noninfectious colitis


Topic Completed: 1 May 2013

Minor changes: 30 September 2020

Copyright: 2003-2021,, Inc.

PubMed Search: Typhlitis

Hanni Gulwani, M.B.B.S.
Page views in 2020: 1,124
Page views in 2021 to date: 932
Cite this page: Gulwani H. Typhlitis. website. Accessed October 25th, 2021.
Definition / general
  • Means inflammation of cecum (eMedicine); a 19th century term for severe acute/chronic inflammation of cecum/appendix, probably due to untreated acute appendicitis
  • Currently, represents a life threatening acute inflammatory destruction of cecal mucosa in neutropenic patients, possibly due to impaired mucosal immunity and compromised blood flow; also associated with secondary bacteria and fungal overgrowth but minimal active inflammation (due to neutropenia)
  • Also called hemorrhagic necrosis of bowel wall, neutropenic colitis
  • Often leukemia or lymphoma patients after immunosuppressive therapy
  • Mechanism (not known), but probably due to a combination of ischemia, infection (especially with cytomegalovirus), mucosal hemorrhage, and perhaps neoplasia
Clinical features
  • Present with fever, watery or bloody diarrhea, and abdominal pain, may be localized in right lower quadrant (Radiographics 2000;20:399)
  • May cause perforation and require surgery
  • Severity in childhood cancer is related to duration of neutropenia and presence of fever or abdominal tenderness (Cancer 2005;104:380)
  • Usually diagnosed by CT scan due to thickening of cecal wall
Prognostic factors
Case reports
Gross description
  • Inflamed cecum and proximal right colon with hemorrhage and mucosal edema
Microscopic (histologic) description
  • Adherent fibrinopurulent exudate over necrotic and edematous mucosa
Microscopic (histologic) images

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Colonic stenosis in neutropenic patient

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