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January 11, 1993

Successful Surgical Management of Neutropenic Enterocolitis in Two Patients With Severe Aplastic Anemia: Case Reports and Review of the Literature

Author Affiliations

From the Pediatric Branch, Infectious Disease Section (Drs Weinberger and Pizzo) and Laboratory of Pathology (Dr Hollingsworth), National Cancer Institute, National Institutes of Health, Bethesda, Md; Department of Radiology, Warren Grant Magnuson Clinical Center, National Institutes of Health and Georgetown University, Washington, DC (Dr Feuerstein); and Clinical Hematology Branch, National Heart, Lung and Blood Institute, National Institutes of Health (Dr Young). Dr Weinberger is now with the Department of Clinical Microbiology and Infectious Diseases, Hadassah Medical Center, Jerusalem, Israel.

Arch Intern Med. 1993;153(1):107-113. doi:10.1001/archinte.1993.00410010127013

We describe two patients with severe aplastic anemia in whom neutropenic enterocolitis developed while they were undergoing treatment at the National Institutes of Health. Both patients had progressive symptoms while receiving optimal medical management and both underwent and survived surgical intervention despite continued prolonged neutropenia in the perioperative period. This experience contrasts with six cases reported in the literature and suggests that surgery can be employed even in patients with profound neutropenia. Thus, in patients who remain persistently septic or who develop clinical deterioration despite medical management or who have other indications for surgical intervention, neutropenia should not be a contraindication to the appropriate or necessary procedure.

(Arch Intern Med. 1993;153:107-113)