Neutropenic enterocolitis

Neutropenic enterocolitis

    * Introduction
    * Signs and symptoms
    * Diagnosis
    * Treatment
Neutropenic colitis is a life-threatening acute pathological condition characterized by transmural inflammation of the small intestine and thicker in patients who are severely immunosuppressed and myelosuppressive. Clinical presentation can be dramatic and devastating evolution. The mortality rate is high and the treatment controversial, with options ranging from conservative control until surgery. Early recognition of the disorder can lead to a prognostic fevorabil.
In the last three decades the disease has been reported in patients with various myeloproliferative disorders and solid malignant tumors in adults and marrow or organ transplant. Some cases in adults is due to increased administration of myelotoxic regimes. The exact incidence and prevalence are unknown because many patients survive and are never diagnosed. An autopsy study in children reported a prevalence of 24% while a cohort study in children treated for acute myelogenous leukemia reported a frequency of 33%.
Patients who are affected by neutropenic colitis, and anticancer drugs are given neutropenic. Symptoms usually appear 10-14 days after initiation of chemotherapy. Typical presentation mimicking appendicitis. Symptoms include fever, abdominal pain right lower quadrant abdominal blood or watery diarrhea, nausea, vomiting and abdominal distension.
The prognosis appears to be related to patient status and other comorbidities at the time of clinical presentation to the therapeutic method. Can not recommend a uniform regimen. Early recognition of this disease without a favorable evolution. The broad-spectrum antibiotics, intravenous fluids, avoid drugs that predispose to diarrhea. Surgical therapy is indicated in patients with intestinal perforation, clinical deterioration, sepsis or abscess formation and persistent bleeding. The mortality rate varies from 5% to 100% during therapy conswervative averaging 40-50%.
Pathogens.
Neutropenic Nterocolita transmural acute inflammation of the intestine is thinner and thicker in patients who are severely immunosuppressed and myelosuppression. Although the exact etiology is unknown and the disease progression, neutropenia prefunda trigger seems to be common. Many factors have been described as potential Playing roles in the pathogenesis and include the following: -Mucosal injury caused by cytotoxic drugs, however, this lesion appears outside of cytotoxic drugs and neutropenia itself can cause mucosal ulcerations Primary or secondary-alcaloiziloc caecal distension may compromise the intake of blood leading to mucosal damage -Consumption of antibiotics and steroids may contribute to alterations in enteric bacterial flora and fungi with overcrowding Bacterial invasion, can cause inflammation of the intestine affected by transmural perforation and peritonitis, bacteriemeia appellant is a frequent complication.
Pathological process appears to involve only be extended to the cecum or ileum, colon or both. It is believed that caecal distension and limited blood supply of the cecum may predispose to injuries more often than other areas.
Causes and risk factors.
Although cytotoxic chemotherapeutic agents in most cases include other conditions that may predispose some patients to develop this disease include: -Cytotoxic chemotherapeutic agents: cytosine arabinozina, vinca alkaloids, doxorubicin -Other drugs paclitaxel, docetaxel, procainamide, sulfasalazine, 5-fluorouracil, carboplatin, gemcitabine, leucovorin Myelodysplastic syndromes, multiple myeloma, aplastic anemia Solid-organ transplantation and bone marrow AIDS, cyclic neutropenia, solid malignant tumors, lymphomas.