Acute Typhlitis: A Rare Complication of FOLFIRINOX Chemotherapy in the Treatment of Advanced Pancreatic Cancer


South Atlantic


Grand Strand Medical Center

Document Type

Case Report

Publication Date



FOLFIRINOX, Typhlitis, Neutropenic enterocolitis, Pancreatic cancer


Digestive System Diseases | Internal Medicine | Neoplasms


FOLFIRINOX is a combination of multiple chemotherapeutic agents, commonly used to treat metastatic pancreatic cancer [1]. A less commonly associated side-effect to this chemotherapy regimen is typhlitis, also known as neutropenic enterocolitis (NEC). This is a life-threatening condition that occurs secondary to cytotoxic damage of the gastrointestinal mucosal wall, particularly the cecum [2]. This loss of mucosal wall integrity subsequently leads to infection and inflammation. As such, immunosuppressed patients exposed to highly cytotoxic agents are of higher risk for translocation of gut bacteria and eventually septic shock. Our case report reviews the diagnosis, management and impact of typhlitis secondary to FOLFIRINOX therapy. Typhlitis should always be suspected when a patient undergoing active chemotherapy presents to an acute care facility with Right Lower Quadrant (RLQ) abdominal pain, fever and neutropenia. Nonetheless, this life-threatening diagnosis is often missed.

Publisher or Conference

International Journal of Clinical Studies and Medical Case Reports