Therefore, the diagnosis of acute abdomen may be delayed in these patients [7]. Neutropenia is being encountered more commonly in clinical practice and may be because of Acute Nonlocalized Abdominal Pain cytotoxic chemotherapy or immunosuppressive therapy. Colitidies and enteritidies are commonly found in this patient population, including clostridium difficile colitis, cytomegalovirus colitis, graft-versus-host disease, neutropenic enterocolitis, and bowel ischemia and perforation [8,56]. One study reported the most frequent causes of abdominal pain are neutropenic enterocolitis (28%) and SBO (12%) [8]. Atypical and opportunistic infections, chemotherapeutic-related mucosal injury, and tumors can all result in bowel pathology, and are commonly approached with IV contrast-enhanced CT as the initial imaging modality. Radiography Abdomen There are no recent studies that evaluate the use of radiography in the setting of acute nonlocalized or diffuse abdominal pain in the neutropenic patient. Radiography demonstrates low overall sensitivity in the detection of colitidies and enteritidies, and even low-dose CT demonstrates superior diagnostic yield in comparison with abdominal radiography [16]. Many authors suggest that radiographs have a limited role in the evaluation of nontraumatic abdominal pain in adults [17-22]. Fluoroscopy Contrast Enema There are no recent studies evaluating the use of contrast enema in the setting of acute nonlocalized or diffuse abdominal pain in the neutropenic patient. Fluoroscopy Upper GI with SBFT There are no recent studies evaluating the use of upper GI series with SBFT in the setting of acute nonlocalized or diffuse abdominal pain in the neutropenic patient. CT is often the initial imaging study to diagnose small bowel pathology in the immunocompromised patient, but occasionally barium studies may offer additional complementary information when mucosal lesions are small.
Acute Nonlocalized Abdominal Pain. Therefore, the diagnosis of acute abdomen may be delayed in these patients [7]. Neutropenia is being encountered more commonly in clinical practice and may be because of Acute Nonlocalized Abdominal Pain cytotoxic chemotherapy or immunosuppressive therapy. Colitidies and enteritidies are commonly found in this patient population, including clostridium difficile colitis, cytomegalovirus colitis, graft-versus-host disease, neutropenic enterocolitis, and bowel ischemia and perforation [8,56]. One study reported the most frequent causes of abdominal pain are neutropenic enterocolitis (28%) and SBO (12%) [8]. Atypical and opportunistic infections, chemotherapeutic-related mucosal injury, and tumors can all result in bowel pathology, and are commonly approached with IV contrast-enhanced CT as the initial imaging modality. Radiography Abdomen There are no recent studies that evaluate the use of radiography in the setting of acute nonlocalized or diffuse abdominal pain in the neutropenic patient. Radiography demonstrates low overall sensitivity in the detection of colitidies and enteritidies, and even low-dose CT demonstrates superior diagnostic yield in comparison with abdominal radiography [16]. Many authors suggest that radiographs have a limited role in the evaluation of nontraumatic abdominal pain in adults [17-22]. Fluoroscopy Contrast Enema There are no recent studies evaluating the use of contrast enema in the setting of acute nonlocalized or diffuse abdominal pain in the neutropenic patient. Fluoroscopy Upper GI with SBFT There are no recent studies evaluating the use of upper GI series with SBFT in the setting of acute nonlocalized or diffuse abdominal pain in the neutropenic patient. CT is often the initial imaging study to diagnose small bowel pathology in the immunocompromised patient, but occasionally barium studies may offer additional complementary information when mucosal lesions are small.