Friday, April 29, 2011
Taxanes and Neutropenic Colitis
One of the dreaded complications of taxane-based chemotherapy agents is severe neutropenic colitis. The images above are pretty classic. Mortality rates approach 50%. Surgical treatment is usually an ileocolectomy with an ileostomy. When I saw this particular patient, there wasn't much to be done. He had extensive mottling of his legs and abdominal wall and, hemodynamically, he was already starting to crash. (As an aside, mottling is one of the most ominous random clinical findings you can encounter. The bluish-black stippling of the skin is an imprint of death itself.