Colon
Noninfectious colitis
Typhlitis
Author: Hanni Gulwani, M.B.B.S.
Last author update: 1 May 2013
Last staff update: 12 October 2023
Copyright: 2003-2024, PathologyOutlines.com, Inc.
PubMed Search: Typhlitis
Table of Contents
Definition / general | Clinical features | Diagnosis | Prognostic factors | Case reports | Gross description | Microscopic (histologic) descriptionCite this page: Gulwani H. Typhlitis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/colontyphlitis.html. Accessed April 18th, 2024.
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)
Diagnosis
- Usually diagnosed by CT scan due to thickening of cecal wall
Prognostic factors
- Poor prognosis overall with death in up to 50% (Rev Esp Enferm Dig 2003;95:30)
Case reports
- 73 year old man with small cell lung carcinoma and typhilitis after chemotherapy with irinotecan and cisplatin (Tuberc Respir Dis (Seoul) 2012;73:288)
- Typhlitis in non-small cell lung cancer (Lung Cancer 2009;65:251)
Gross description
- Inflamed cecum and proximal right colon with hemorrhage and mucosal edema
Microscopic (histologic) description
- Adherent fibrinopurulent exudate over necrotic and edematous mucosa
