Abdominal Pain Associated with Neutropenia

Clinical Image

Ann Transl Med Epidemiol. 2015; 2(1): 1007.

Abdominal Pain Associated with Neutropenia

Hyewon Ryu, Hyo Jin Lee*

Department of Internal Medicine, Chungnam National University School of Medicine, Republic of Korea

*Corresponding author: Hyo Jin Lee, Department of Internal Medicine, Chungnam National University Hospital, 640 Daesa-dong, Jung-gu, Daejeon 35015, Republic of Korea

Received: September 23, 2015; Accepted: September 25, 2015; Published: September 28, 2015

Keywords

Typhlitis; Neutropenia; Chemotherapy; Abdominal Pain

Clinical Image

A 57-year-old woman with metastatic leiomyosarcoma started palliative chemotherapy with doxorubicin (20 mg/m2 day 1-3), ifosfamide (2,500 mg/m2 day 1-3) and dacarbazine (300 mg/m2 day 1-3) with mesna (2,500 mg/m2 day 1-4) uroprotection. Ten days after the sixth cycle, the patient presented with fever and abdomina pain with direct and rebound tenderness in right abdomen. Laboratory data revealed a severe hematological toxicity, with grade 4 neutropenia (neutrophil count of 20/mm3 with a white blood cell count of 240/mm3) and grade 3 thrombocytopenia (29,000/mm3). Serum chemistries were unremarkable. Computed tomography of the abdomen and pelvis showed severe edematous wall thickening in terminal ileum, ileocecal valve (arrows), cecum, and proximal ascending colon with luminal collapse and pericolic stranding (Figure 1A–1B).

Citation: Ryu H, Lee HJ. Abdominal Pain Associated with Neutropenia. Ann Transl Med Epidemiol. 2015; 2(1): 1007. ISSN:2472-3649