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World J Gastroenterol. Jan 7, 2017; 23(1): 42-47
Published online Jan 7, 2017. doi: 10.3748/wjg.v23.i1.42
Neutropenic enterocolitis
Fabio G Rodrigues, Giovanna Dasilva, Steven D Wexner
Fabio G Rodrigues, Giovanna Dasilva, Steven D Wexner, Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL 33331, United States
Author contributions: Rodrigues FG, Dasilva G and Wexner SD contributed equally to this work including designing and performing the research, analyzing the data, and writing the paper.
Conflict-of-interest statement: The authors have no relevant financial disclosures.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Steven D Wexner, MD, PhD (Hon), Department of Colorectal Surgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL 33331, United States. wexners@ccf.org
Telephone: +1-954-6596020
Received: June 8, 2016
Peer-review started: June 13, 2016
First decision: October 20, 2016
Revised: November 18, 2016
Accepted: December 8, 2016
Article in press: December 8, 2016
Published online: January 7, 2017
Processing time: 211 Days and 1 Hours
Abstract

Neutropenic colitis is a severe condition usually affecting immunocompromised patients. Its exact pathogenesis is not completely understood. The main elements in disease onset appear to be intestinal mucosal injury together with neutropenia and the weakened immune system of the afflicted patients. These initial conditions lead to intestinal edema, engorged vessels, and a disrupted mucosal surface, which becomes more vulnerable to bacterial intramural invasion. Chemotherapeutic agents can cause direct mucosal injury (mucositis) or can predispose to distension and necrosis, thereby altering intestinal motility. This article aims to review current concepts regarding neutropenic colitis’ pathogenesis, diagnosis, and management.

Keywords: Neutropenic enterocolitis; Neutropenic colitis; Immunocompromise; Intestinal mucosal injury; Neutropenia; Intestinal edema; Intramural invasion; Pathogenesis

Core tip: Neutropenic colitis is a severe condition usually affecting immunocompromised patients. Its exact pathogenesis is not completely understood. The main elements in disease onset appear to be intestinal mucosal injury together with neutropenia and the weakened immune system of the afflicted patients. These initial conditions lead to intestinal edema, engorged vessels, and a disrupted mucosal surface, which becomes more vulnerable to bacterial intramural invasion. Chemotherapeutic agents can cause direct mucosal injury or can predispose to distension and necrosis, thereby altering intestinal motility.