Isolated inflammatory process of the caecum

Czech version

Authors: L. Truong; H. H. Truong; P. Kofroň
Authors‘ workplace: Chirurgické oddělení, FN Plzeň
Published in: Rozhl. Chir., 2025, roč. 104, č. 2, s. 71-75.
Category: Case Report
doi: https://doi.org/10.48095/ccrvch202571

Overview

Acute abdomen represents a large complex of acute situations in general surgery. There could be inflammatory (such as acute appendicitis, acute cholecystitis etc.), non-inflammatory (ileus), hemorrhage or traumatic situations (perforation of the gastrointestinal tract etc.). Our work presents two case reports of two not significantly ill female patients with an uncommon inflammatory process of the caecum. Acute typhlitis is an archaism for most of surgeons. It used to be a synonym for acute appendicitis; however, the modern literature defines this diagnose as a different disease – neutropenic enterocolitis. It is a rare but serious disease causing a right lower quadrant pain, often mimics acute appendicitis. Usually, it occurs in immunocompromised patients (patients after an immunosuppressive therapy, neutropenic patients, people with hematologic malignancies, AIDS positive patients, etc.); however, a few case reports of entirely healthy patients have been published. Nevertheless, there is however a limited number of these cases.

Keywords:

acute abdomen – Neutropenia – case report – caecum – caecal necrosis – ischemic colitis – typhlitis – neutropenic enterocolitis

Sources

1. Suleimanov V, Shahzad F. Partial infarction of cecal wall presenting as acute appendicitis. Cureus 2022; 14(11): e31408. doi: 10.7759/cureus.31408.

2. Dirican A, Unal B, Bassulu N et al. Isolated cecal necrosis mimicking acute appendicitis: a case series. J Med Case Rep 2009; 3: 7443. doi: 10.4076/1752-1947-3-7443.

3. Gorschlüter M, Mey U, Strehl J et al. Neutropenic enterocolitis in adults: systematic analysis of evidence quality. Eur J Haematol 2005; 75(1): 1–13. doi: 10.1111/j.1600-0609.2005.00442.x.

4. Centers for Disease Control and Prevention (CDC). Fatal foodborne Clostridium perfringens illness at a state psychiatric hospital – Louisiana, 2010. MMWR Morb Mortal Wkly Rep 2012; 61(32): 605–608.

5. Sobel J, Mixter CG, Kolhe P et al. Necrotizing enterocolitis associated with clostridium perfringens type A in previously healthy north american adults. J Am Coll Surg 2005; 201(1): 48–56. doi: 10.1016/j.jamcollsurg.2005.02.029.

6. Reyes JV, Sayed SB, Seen T et al. Typhlitis: a rare appendicitis mimic in a young healthy female. Cureus 2021; 13(6): e15839. doi: 10.7759/cureus.15839.

7. Saillard C, Zafrani L, Darmon M et al. The prognostic impact of abdominal surgery in cancer patients with neutropenic enterocolitis: a systematic review and meta-analysis, on behalf the Groupe de Recherche en Réanimation Respiratoire du patient d‘Onco-Hématologie (GRRR-OH). Ann Intensive Care 2018; 8(1): 47. doi: 10.1186/s13613-018-0394-6.

8. Aapro MS, Cameron DA, Pettengell R et al. EORTC guidelines for the use of granulocyte-colony stimulating factor to reduce the incidence of chemotherapy-induced febrile neutropenia in adult patients with lymphomas and solid tumours. Eur J Cancer 2006; 42(15): 2433–2453. doi: 10.1016/ j.ejca.2006.05.002.

9. Bhana N. Granulocyte colony- -stimulating factors in the management of chemotherapy-induced neutropenia: evidence based review. Curr Opin Oncol 2007; 19(4): 328–335. doi: 10.1097/01.cco.0000275309.58868.11.

10. Hunter JP, Saratzis A, Zayyan K. Spontaneous, isolated caecal necrosis: report of a case, review of the literature, and updated classification. Acta Chir Belg 2013; 113(1): 60–63. doi: 10.1080/00015458.2013.11680889.

MUDr. Liliana Truong

Chirurgické oddělení

FN Plzeň

Dr. E. Beneše 13

305 99 Plzeň

truongli@fnplzen.cz