Korean Journal of Pediatrics 2008;51(2):156-161.
Published online February 15, 2008.
Outcome of typhlitis in children with cancer
Jae Min Lee, Kwang Hae Choi, Jeong Ok Hah
Department of Pediatrics, College of Medicine, Yeungnam University, Daegu, Korea
소아암 환자에서 발생한 막창자염(typhlitis)의 치료성적
이재민, 최광해, 하정옥
영남대학교 의과대학 소아과학교실
Correspondence: 
Jeong Ok Hah, Email: johah@med.yu.ac.kr
Abstract
Purpose
: Neutropenic enterocolitis is an acute, life-threatening inflammation of the small and large bowel, often seen in children with malignancies during periods of prolonged or severe neutropenia. The optimal management for typhlitis in pediatric oncology patients has been debateful between operative and nonoperative approaches. The purpose of this study was to review the outcome of medical management of patients who were diagnosed as typhlitis.
Methods
: The records of 207 pediatric cancer patients who were diagnosed and treated at the pediatric department of Yeungnam University Hospital for cancer between August, 2002 and July, 2007 were reviewed.
Results
: Among 207 patients, 12 (5.7%) children aged 9 to 14 years, were diagnosed clinically to have typhlitis. Clinical symptoms and signs of patients were fever, abdominal pain and tenderness, diarrhea, vomiting and rebound tenderness. Bowel-wall thickening (> 4mm) was seen on CT or ultrasonography. All patients were treated with antibiotics combinations of teicoplanin, carbapenem, aminoglycoside, or other third generation cephalosporin and metronidazole or clindamycin. Eight patients were treated with additional antifungal agents. Other supportive management included bowel rest, total parenteral nutrition, and G-CSF administration. All patients recovered completely and did not need any surgical management.
Conclusion
: Early diagnosis and aggressive supportive treatment appears to be important for complete recovery and survival of typhlitis.
Key Words: Typhlitis, Enterocolitis, Neutropenia


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