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Typhlitis or typhlenteritis, less commonly called caecitis or cecitis, is an inflammation of the cecum (part of the large intestine) that may be associated with infection.^[1]

Cause

The condition is usually caused by Gram-positive enteric commensal bacteria of the gut (gut flora). Clostridium difficile is a species of Gram-positive bacteria that commonly causes severe diarrhea and other intestinal diseases when competing bacteria are wiped out by antibiotics.

Typhlitis affects immunocompromised patients, such as those undergoing chemotherapy,^[2] patients with AIDS, kidney transplant patients, or the elderly.^[3]

Signs and symptoms

Signs and symptoms of typhlitis may include diarrhea, a distended abdomen, fever, chills, nausea, vomiting, and abdominal pain or tenderness.^[3]

Prognosis

Inflammation can spread to other parts of the gut in patients with caecitis.^{[citation needed]} The condition can also cause the cecum to become distended and can cut off its blood supply. This and other factors can result in necrosis and perforation of the bowel, which can cause peritonitis and sepsis.^[4] The mortality rate for caecitis can be as high as 50%, mostly because it is frequently associated with bowel perforation.^[3] Caecitis is diagnosed with a radiograph CT scan showing thickening of the cecum and "fat stranding".^{[citation needed]}

Treatment

Typhlitis is a medical emergency. It has a very poor prognosis and is often fatal unless promptly recognized and aggressively treated.^[2]

Successful treatment hinges on:

Early diagnosis provided by a high index of suspicion and the use of CT scanning
Nonoperative treatment for uncomplicated cases
elective right hemicolectomy to prevent recurrence

"...The authors have found nonoperative treatment highly effective in patients who do not manifest signs of peritonitis, perforation, gastrointestinal hemorrhage, or clinical deterioration. Recurrent typhlitis was frequent after conservative therapy (recurrence rate, 67 percent), however."^[2]

References

^ Definition at thefreedictionary.com
^ ^a ^b ^c Keidan, RD; Fanning, Gatenby, Weese (Mar 1989). "Recurrent typhlitis. A disease resulting from aggressive chemotherapy". Dis Colon Rectum. 32(3): 206–9. doi:10.1007/BF02554529. PMID 2920627. |accessdate= requires |url= (help)
^ ^a ^b ^c Stoehr TM and Koslin DB. 2004. Typhlitis Imaging. emedicine.com.
^ L Boggio1, R Pooley2, S I Roth2 and J N Winter1 Typhlitis complicating autologous blood stem cell transplantation for breast cancer Nature, February 2000, Volume 25, Number 3, Pages 321-326

UpToDate Contents

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1. 盲腸炎（好中球減少性腸炎） typhlitis neutropenic enterocolitis
2. 新生児における壊死性腸炎の臨床的特徴および診断 clinical features and diagnosis of necrotizing enterocolitis in newborns
3. 新生児における壊死性腸炎のマネージメント management of necrotizing enterocolitis in newborns
4. 新生児における壊死性腸炎の病理および病因 pathology and pathogenesis of necrotizing enterocolitis in newborns
5. 新生児における壊死性腸炎の予防 prevention of necrotizing enterocolitis in newborns

English Journal

Colorectal cancer emergencies.

Barnett A, Cedar A, Siddiqui F, Herzig D, Fowlkes E, Thomas CR Jr.SourceDepartment of Emergency Medicine, Oregon Health & Science University, Portland, OR 97239-3098, USA.
Journal of gastrointestinal cancer.J Gastrointest Cancer.2013 Jun;44(2):132-42. doi: 10.1007/s12029-012-9468-0.
INTRODUCTION: Colorectal cancer (CRC) is a common type of malignancy encountered in the United States. A significant proportion of patients with CRC will seek emergency medical care during the course of their illness and treatment.BACKGROUND: Emergent presentations can be the result of either local
PMID 23371864

Pemetrexed-induced neutropenic enteritis and severe cutaneous hyperpigmentation in a patient with malignant pleural mesothelioma.

Buchinger K, Stahel R, Niggemeier V, Gubler C, Franzen D.SourceDepartment of Internal Medicine, University Hospital Zurich, Zurich, Switzerland.
Lung cancer (Amsterdam, Netherlands).Lung Cancer.2013 Jun;80(3):347-9. doi: 10.1016/j.lungcan.2013.02.019. Epub 2013 Mar 19.
Neutropenic enteritis (NE) or enterocolitis (NEC) is a rare, but potentially life-threatening side effect of neutropenia-inducing chemotherapy agents. Generally, its occurrence is attributed to leukemia-associated chemotherapies. Two cases of NE have been reported after the appliance of pemetrexed f
PMID 23522487

Japanese Journal

Neutropenic Enterocolitis in Children with Acute Leukemia or Aplastic Anemia

ALIOGLU Bulent,AVCI Zekai,OZCAY Figen,ARDA Serdar,OZBEK Namik
International journal of hematology 86(4), 364-368, 2007-11-15
NAID 10019990307

急性骨髄性白血病の寛解導入療法による骨髄抑制期に好中球減少性腸炎および急性虫垂炎を発症した1例

小高雅人,杉藤正典,小林昭広,小畠誉也,矢野匡亮,斉藤典男
日本消化器外科学会雑誌 40(1), 124-128, 2007-01-01
症例は42歳の男性で,点状出血および発熱を契機に急性骨髄性白血病(MO)と診断され,化学療法を施行された.その17日後に右下腹部痛が出現し,腹部CTで上行結腸から盲腸にかけて壁肥厚を認めたため,好中球減少性腸炎と診断したが,骨髄抑制期であることと腹部所見を考慮し保存的治療を選択した.その後症状は軽快したが,下部消化管内視鏡所見で虫垂より膿の排出を認めたため,虫垂炎と診断し,虫垂切除術を施行した.組 …
NAID 110006152562