Neutropenic enterocolitis: a serious complication during the treatment of acute leukemias

Neutropenic enterocolitis (NE) is a severe gastrointestinal complication in patients who undergo aggressive chemotherapy. It is a necrotizing inflammation of the cecum, colon, and the terminal part of the ileum. The serious clinical state of NE patients requires very frequent surgical consultations; however, in a few particular cases of NE, e.g., perforation of the bowels, a surgical intervention is necessary. Here, we report on six cases of NE in patients with acute leukemias. The patients were all women aged 21–55 years. Two of them had acute myeloid leukemia and four had lymphoblastic leukemia. NE occurred 7–10 days after the completion of chemotherapy, during the neutropenic phase. They represented a typical picture of NE: two of them died because of septic shock; five patients had subileus with irritation of the peritoneum; and one had hepatosplenic abscesses confirmed 6 months later by post-mortem examination. In each case, a surgical opinion was required. None of these patients were operated on. We present a report summarizing our experience and problems with six patients who had a clinical picture of NE and offer a short review of the current literature on the subject.