RESUMO
INTRODUCTION: Typhlitis is a rare condition, characterized by necrotizing inflammation of the colon. It occurs mainly in neutropenic patients receiving chemotherapy for leukemia. EXEGESIS: We report the case of a 64-year-old woman with T-cell lymphocytic leukaemia, who exhibited asymptomatic reactivation of cytomegalovirus infection and developed subsequently typhlitis. CONCLUSION: The pathological mechanisms of typhlitis remain unclear in neutropenic patients. The role of cytotoxic drugs as well as both bacterial overgrowth and translocation has been postulated. In our patient, asymptomatic reactivation of cytomegalovirus infection may have increased chemotherapeutic-agents-digestive toxicity.
Assuntos
Enterocolite Neutropênica/diagnóstico , Leucemia de Células T/tratamento farmacológico , Tiflite/etiologia , Alemtuzumab , Antibacterianos/uso terapêutico , Anticorpos Monoclonais/administração & dosagem , Anticorpos Monoclonais/efeitos adversos , Anticorpos Monoclonais/uso terapêutico , Anticorpos Monoclonais Humanizados , Anticorpos Antineoplásicos/administração & dosagem , Anticorpos Antineoplásicos/efeitos adversos , Anticorpos Antineoplásicos/uso terapêutico , Antineoplásicos/administração & dosagem , Antineoplásicos/efeitos adversos , Antineoplásicos/uso terapêutico , Antivirais/uso terapêutico , Translocação Bacteriana , Infecções por Citomegalovirus/tratamento farmacológico , Infecções por Citomegalovirus/etiologia , Infecções por Citomegalovirus/microbiologia , Enterocolite Neutropênica/tratamento farmacológico , Enterocolite Neutropênica/terapia , Feminino , Ganciclovir/análogos & derivados , Ganciclovir/uso terapêutico , Humanos , Pessoa de Meia-Idade , Radiografia Abdominal , Tomografia Computadorizada por Raios X , Tiflite/induzido quimicamente , Tiflite/diagnóstico , Tiflite/diagnóstico por imagem , Tiflite/tratamento farmacológico , Tiflite/terapia , ValganciclovirRESUMO
The authors report a case of a complete pancreatic neck rupture treated by conservative surgery. A pancreatic neck rupture was diagnosed on a CT scan performed 24 hours after an abdominal blunt trauma. The patient was treated by suture of the cephalic remnant and Roux-en-Y pancreaticojejunostomy on the left remnant. Postoperative course was uneventful and the patient did not develop diabetes with a 18-month follow-up. This conservative technique, rarely used for complete pancreatic neck rupture, allows preservation of the pancreatic endocrine function.