嗜中性白血球缺乏性腸炎(neutropenic entercolitis, NEC) ，好發於血液惡性腫瘤（例如血癌、淋巴癌、多發性骨髓瘤、再生不良性貧血、骨髓再生不良症候群）或免疫低下及白血球過低的病人（例如AIDS、骨髓移植、各種器官移植，以及各種實質性惡性腫瘤接受化學治療的病人），發生率約為上述疾病住院者的5 至6%。若病人併發腸穿孔及敗血症，則死亡率達一半以上。化學治療是導致黏膜受損的直接原因，腸道受血癌細胞侵襲及浸潤可能是NEC的另一原因，所以NEC有時可以發生在化學治啟動之前。本病最常侵犯廻腸及盲腸，但是也可能侵犯小腸及大腸的其他部位，電腦斷層是目前診斷本疾病最佳的的工具。治療方面以保守治療為主，病人必須空腹禁食，適量輸液，使用廣效抗生素，這些抗生素必須能夠涵蓋大腸桿菌、綠膿桿菌及腸球菌，例如合併使用ceftazidime及cefepime ，有時還須加上metronidazole治療厭氧菌。若中性白血球少於500/103/uL時，應使用白血球生長激素(granulocytecolony stimulating factor, G-CSF)。手術治療只限於腸穿孔，無法控制的腸出血或腸壞死。本文報告一位中年男性，罹患糖尿病多年，但血糖控制不佳，2022 年7 月發現右肺小細胞癌因此入院化療，使用減必治(etoposide) 口服藥及克莫抗癌(cisplatin)靜脈注射，化療之後第十二天，因右下腹痛作電腦斷層發現迴腸末端、盲腸及上行結腸腫脹，再加上絕對嗜中性白血球(absolute neutrophilic count, ANC) 低到200/103/uL，因此診斷為NEC，因為即早使用廣效抗生素及白血球生長激素，病情迅速好轉。

Neutropenic colitis (NEC) is usually reported in patients with hematologic malignancies such as leukemia, lymphoma, multiple myeloma, aplastic anemia, and myelodysplastic syndromes, as well as other immunosuppressive causes such as AIDS, therapy for solid tumors, and organ transplant. The incidence of NE is about 5-6% in hospitalized adults .The reported mortality also varies with rates as high as 50% in bowel perforation. Chemotherapy can induce intestinal mucosal injury together with neutropenia and the immunocompromised state of the afflicted patients. Intestinal leukemic infiltration is another potential factor in the pathogenesis of NE, which may explain the presence of acute myelogenous leukemia presenting as NEC before the onset of chemotherapy. The cecum is always affected by NEC and very often extends to the ileum and other parts of small bowel and colon. CT scan is the most useful diagnostic tool. Conservative management consists of bowel rest, aggressive fluid resuscitation, and broad-spectrum antibiotics. The antibiotics must covers E.Coli, pseudomonas, entercoccus and anaerobic bacteria. Granulocyte colony stimulating factor(G-CSF) is suggested if granulocyte is less than 500/cumm. The indications for surgery in NEC are evidence of intraperitoneal bowel perforation, uncontrolled bleeding or bowel necrosis. We presented a middle-aged male who had diabetes mellitus for many years. The DM control was poor. He was admitted to our hospital for small cell cancer of right lung in July 2022. Chemotherapy was performed with etoposide and cisplatin. Right lower abdominal pain was complained at 12th day after chemotherapy. Initially appendicitis or diverticulitis of colon was suspected ,but computerized tomography of abdomen revealed bowel wall thickening in the cecum,ascending colon and terminal ileum. Complete blood count showed neutropenia with absolute neutrophilic count less than 500 /10^3/uL. Neutropenic entercolitis was impressed. After use of ertapenum ,cefpime.metronidazole and granulocyte colony stimulating fator, he recoverd uneventfully 8 days later.