Treatment of Appendicitis in Neutropenic Children

Mortellaro, Vincent E.; Juang, David; Fike, Frankie B.; Saites, Constantine G.; Potter, D. Dean; Iqbal, Corey W.; Snyder, Charles L.; Peter, Shawn D. St.

doi:10.1016/j.jss.2011.03.061

Cited by 29 publications

(20 citation statements)

References 15 publications

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“…Although successful conservative management has been reported [9] , the majority require surgical intervention to avoid devastating complications [1,10] . Several groups have demonstrated safety and efficacy of surgical intervention [1,4,10] and operative management may also shorten the length of hospital stay compared to nonoperative management [10] . In our cohort, all three patients were operated upon emergently and all of them including the patient with appendiceal perforation and leukemic infiltration tolerated surgery well.…”

Section: Discussionmentioning

confidence: 99%

Acute appendicitis in acute leukemia and the potential role of decitabine in the critically ill patient

Warad

Kohorst

Altaf

et al. 2015

Leukemia Research Reports

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Acute appendicitis in children with acute leukemia is uncommon and often recognized late. Immunocompromised host state coupled with the importance of avoiding treatment delays makes management additionally challenging. Leukemic infiltration of the appendix though rare must also be considered. Although successful conservative management has been reported, surgical intervention is required in most cases. We present our experience with acute appendicitis in children with acute leukemia and a case of complete remission of acute myeloid leukemia with a short course of decitabine. Decitabine may serve as bridging therapy in critically ill patients who are unable to undergo intensive chemotherapy.

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Section: Discussionmentioning

confidence: 99%

Acute appendicitis in acute leukemia and the potential role of decitabine in the critically ill patient

Warad

Kohorst

Altaf

et al. 2015

Leukemia Research Reports

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“…Of the surgical patients, nine had uneventful recoveries, three had complications (including infection and intraoperative bleeding), and one died [4]. In several recent studies, neither operative morbidity nor mortality was observed following open or laparoscopic appendectomies [2,3,5]. Moreover, these studies support early surgical intervention in leukemic patients with appendicitis because symptoms are resolved more quickly and hospital stays are shorter [3].…”

Section: Discussionmentioning

confidence: 82%

“…In several recent studies, neither operative morbidity nor mortality was observed following open or laparoscopic appendectomies [2,3,5]. Moreover, these studies support early surgical intervention in leukemic patients with appendicitis because symptoms are resolved more quickly and hospital stays are shorter [3]. Laparoscopic appendectomy appears to be the preferred procedure, resulting in a small wound, fewer wound infections, less pain, rapid recovery, and lower risk of hemorrhagic complications [4,16].…”

Section: Discussionmentioning

confidence: 97%

“…Acute appendicitis is a primary cause in these cases, but its presentation is often aberrant, increasing the challenges in diagnosis and management. The optimal treatment approach for these cases of acute appendicitis remains an area of ongoing controversy [2,3]. However, studies describing acute appendicitis in children with hematological malignancies are scarce, and available information originates largely from a limited number of retrospective studies and case reports [2,4,5].…”

Section: Introductionmentioning

confidence: 99%

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Acute Appendicitis in a Child With Acute Leukemia and Chemotherapy-Induced Neutropenia: A Case Report and Literature Review

Ali

Alhindi

Alalwan

2020

Cureus

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Acute appendicitis is a rare but important complication in children with leukemia. It can be difficult to diagnose, and it has a complicated disease course, especially in patients receiving chemotherapy. Awareness of these complications is critical, particularly in cases where surgical intervention is required. We report a child with T-cell acute lymphoblastic leukemia and chemotherapy-induced neutropenia who presented with acute appendicitis. He was successfully treated with broad-spectrum empiric antibiotics and a delayed laparoscopic appendectomy.

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“…Others advocate for laparoscopic appendectomy in patients with pancytopenia as it has been associated with decreased postoperative infection, hemorrhagic complications, and a lower mortality rate [10]. One particular case series involving children with acute leukemia showed mixed use of open and laparoscopic appendectomy in patients with a mean absolute neutrophil count of 800 cells/m 3 and boasted no intraoperative or postoperative complications [11]. There is no data large enough to determine statistical efficacy of appendectomy among adult transplant patients, and the use of appendectomy in HCT remains anecdotal but an effective treatment for patients in various stages of hematopoietic recovery [2,4,5].…”

Section: Discussionmentioning

confidence: 99%