History:
Eleven-year-old boy with history of acute lymphocytic leukemia, who has been treated with chemotherapeutic agents, presented with fever and abdominal pain.
1. Based on the imaging findings in the following figures what is the most likely diagnosis?
A. Crohns disease
B. Amoebic colitis
C. Typhlitis
D. Ulcerative colitis of the cecum
E. Adenocarcinoma of the cecum
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2. Regarding typhlitis, which statement is false?
A. It is found in patients with leukemia and aplastic anemia or chemotherapy-induced neutropenia.
B. The most common symptom is diarrhea and abdominal pain.
C. Cytomegalovirus, E. Coli and Bacteroidis flagilis has been reported to be the causative agent.
D. The affected bowel loops show the same pathological findings as necrotizing enterocolitis.
E. Ultrasonography cannot detect bowel abnormalities of typhlitis.
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3. Regarding imaging of typhlitis, which statement is false?
A. Thumb printing and bowel wall edema can be found on plain radiographs.
B. Intramural air is a feature of typhlitis.
C. On ultrasound, marked bowel wall thickening is a feature.
D. A barium enema is a useful imaging modality for the diagnosis of thyphlitis. It may delineates the typical thumb printing appearance of the affected bowel.
E. Pancolitis is a feature of typhlitis
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References:
1. Stringer DA. Infection and inflammation. In: Pediatric Gastrointestinal Imaging, 3rd edn. Mosby Company, St Louis, Missouri: 404-6.
2. Parker BR. Abdomen and gastrointestinal tract. In: Kuhn JP, Slovis TL, Haller JO. Caffey’s: Pediatric diagnostic imaging. Mosby Company. Philadephia: 1679-81