This 62 y/o male undergoing chemotherapy for Chronic Lymphocytic Leukemia developed abdominal pain, fever and diarrhea. Lab studies for C. difficile were negative. Selected images from his abdominal CT scan shown above demonstrate thickening of the wall of the cecum with surrounding abnormal soft tissue attenuation in the pericolonic fat consistent with inflammatory changes. This combination of findings is consistent with neutropenic typhlitis/enterocolitis, a severe necrotizing enteropathy. It is an increasingly recognized, life-threatening complication of aggressive chemotherapy mainly for lymphoproliferative and hematologic malignancies although other etiologies are recognized.