Typhlitis refers to a necrotizing colitis involving the cecum or the cecum and appendix, and is found in leukemic children. The term neutropenic enteropathy is also used to refer to these clinical findings. The vaguely defined clinical diagnosis of typhlitis is difficult, but frequent symptoms include abdominal pain, fever, tenderness on exam, and diarrhea. Typhlitis and appendicitis appear to be equally common in the young leukemic patient with right lower quadrant signs of peritoneal irritation. The classical signs of peritoneal irritation can be found in these patients despite their neutropenia and immunosuppressed condition, and have the same implications as in the nonleukemic patient. Plain radiographs are nonspecific but may demonstrate a fluid-filled mass like density in the right lower quadrant, distension of adjacent small bowel loops, and thumb printing. Free intraperitoneal air and pneumatosis coli rarely are observed. The early use of computed tomography scanning helps to facilitate the diagnosis and may provide the ability to differentiate typhlitis from other abdominal diseases for which surgery would be indicated. In typhlitis, computed tomography scan demonstrates cecal distention and circumferential thickening of the cecal wall, which may have low attenuation secondary to edema.