TY - JOUR
T1 - Selective management of patients with neutropenic enterocolitis using peritoneal lavage
AU - Sauter, Edward R.
AU - Vauthey, Jean Nicolas
AU - Bolton, John S.
AU - Sardi, Armando
N1 - Copyright:
Copyright 2016 Elsevier B.V., All rights reserved.
PY - 1990/9
Y1 - 1990/9
N2 - Neutropenic enterocolitis is a symptom complex of fever, abdominal pain, distention, nausea, vomiting, diarrhea, and bloody stools occurring in a patient with a low neutrophil count and is most often seen in patients with acute leukemia after a course of chemotherapy. In most cases, neutropenic enterocolitis is a self‐limited condition, but complications of transmural intestinal necrosis and bowel perforation may occur in a small number of patients. Surgical management should be reserved for those patients with bowel wall necrosis or perforation; however, early identification of these patients is difficult. We report our experience with the use of diagnostic peritoneal lavage in three patients with the symptoms and signs of neutropenic enterocolitis. In each case, Gram's stain of lavage fluid revealed no evidence of polymicrobial contamination of the peritoneal cavity. All three patients were managed medically, with resolution of their abdominal symptoms. Peritoneal lavage is helpful in excluding bowel perforation and avoiding unnecessary surgical intervention in patients with neutropenic enterocolitis.
AB - Neutropenic enterocolitis is a symptom complex of fever, abdominal pain, distention, nausea, vomiting, diarrhea, and bloody stools occurring in a patient with a low neutrophil count and is most often seen in patients with acute leukemia after a course of chemotherapy. In most cases, neutropenic enterocolitis is a self‐limited condition, but complications of transmural intestinal necrosis and bowel perforation may occur in a small number of patients. Surgical management should be reserved for those patients with bowel wall necrosis or perforation; however, early identification of these patients is difficult. We report our experience with the use of diagnostic peritoneal lavage in three patients with the symptoms and signs of neutropenic enterocolitis. In each case, Gram's stain of lavage fluid revealed no evidence of polymicrobial contamination of the peritoneal cavity. All three patients were managed medically, with resolution of their abdominal symptoms. Peritoneal lavage is helpful in excluding bowel perforation and avoiding unnecessary surgical intervention in patients with neutropenic enterocolitis.
KW - chemotherapy
KW - leukemia
KW - neutropenia
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U2 - 10.1002/jso.2930450115
DO - 10.1002/jso.2930450115
M3 - Article
C2 - 2381215
AN - SCOPUS:0025034387
SN - 0022-4790
VL - 45
SP - 63
EP - 67
JO - Journal of surgical oncology
JF - Journal of surgical oncology
IS - 1
ER -