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Good functional outcome following severe neutropenic enterocolitis and perforation in a 48-year-old woman undergoing chemotherapy for breast cancer
  1. Richard Fenton1,
  2. Hannah Schneiders2 and
  3. Jeremy Reid3
  1. 1Anaesthetics, Southmead Hospital, Bristol, UK
  2. 2ICU, Yeovil District Hospital NHS Foundation Trust, Yeovil, UK
  3. 3Anaesthesia, Yeovil District Hospital, Yeovil, UK
  1. Correspondence to Dr Richard Fenton; notnef89{at}hotmail.com

Abstract

Neutropenic enterocolitis (NEC) is a life-threatening bowel condition, usually resulting from chemotherapy, with a mortality rate thought to be as high as 50%. Markers of poor prognosis include gastrointestinal perforation and bowel wall thickness radiologically detected to be greater than 10 mm. NEC is associated with severe neutropenia and predominantly affects the large bowel; however, we present a case of severe NEC with oesophageal perforation requiring transfer to a specialist upper gastrointestinal unit for corrective stenting. Despite initial bowel wall thickness of 20 mm in the ascending colon, two discrete episodes of bowel perforation and an inpatient stay totalling 89 days, the patient was discharged with full independence, a good quality of life and a plan for curative mastectomy plus axillary clearance.

  • intensive care
  • infection (gastroenterology)
  • breast cancer
  • chemotherapy
  • gastrointestinal surgery

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Footnotes

  • Contributors RF carried out the bulk of the writing and research required to produce this paper. HS did a significant amount of work editing and refining the work, as well as obtaining consent from the patient and following up with the patient regarding her subsequent management after discharge from intensive care unit. JR was the supervising consultant for the project and was invaluable in suggesting changes to the phrasing and wording of the final piece prior to publication.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer-reviewed.

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