Ultrasound diagnosis of typhlitis

Purpose: Typhlitis, also known as neutropenic colitis, is a rare inflammatory condition and a potentially life-threatening disease process that typically involves the cecum. Delay in diagnosis may lead to a fatal prognosis with a death rate of 21–48%. Ultrasound evaluation of right lower quadrant may lead to an accurate and rapid diagnosis. Methods: We describe the case of a 59-year-old female with advanced Churg–Strauss syndrome treated with cyclophosphamide, with acute right lower quadrant pain. Results: Ultrasound was the first diagnostic step in the diagnosis of typhlitis. Sonographic findings were comparable to CT imaging. Conclusions: Bowel bedside ultrasound evaluation in emergency settings may lead to a prompt and definitive diagnosis. Although CT is considered the gold standard in the diagnosis and staging of neutropenic colitis, ultrasound was able to identify the pathology accurately. Ultrasound findings of typhlitis are highly characteristic, showing circumferential wall thickening with predominant submucosa.