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Conservative management of acute appendicitis in children with hematologic malignancies during chemotherapy-induced neutropenia


Wiegering, V A; Kellenberger, C J; Bodmer, N; Bergstraesser, E; Niggli, F K; Grotzer, M A; Nadal, D; Bourquin, J P (2008). Conservative management of acute appendicitis in children with hematologic malignancies during chemotherapy-induced neutropenia. Journal of Pediatric Hematology/Oncology, 30(6):464-467.

Abstract

The management of acute appendicitis in the febrile neutropenic patient after intensive chemotherapy is controversial. We report our single-center-experience of 5 children diagnosed with appendicitis during febrile neutropenia after chemotherapy for acute leukemia or lymphoma. All patients presented with an isolated appendicitis without signs of overt mucositis or more diffuse enterocolitis. The clinical diagnosis was confirmed by ultrasonography. Perforation with retrocecal abscess was present in 1 patient. Administration of combination antimicrobial regimens including meropenem resulted in complete resolution in all patients. Our observations indicate that acute appendicitis in clinically stable neutropenic cancer patients can be managed conservatively without surgery.

The management of acute appendicitis in the febrile neutropenic patient after intensive chemotherapy is controversial. We report our single-center-experience of 5 children diagnosed with appendicitis during febrile neutropenia after chemotherapy for acute leukemia or lymphoma. All patients presented with an isolated appendicitis without signs of overt mucositis or more diffuse enterocolitis. The clinical diagnosis was confirmed by ultrasonography. Perforation with retrocecal abscess was present in 1 patient. Administration of combination antimicrobial regimens including meropenem resulted in complete resolution in all patients. Our observations indicate that acute appendicitis in clinically stable neutropenic cancer patients can be managed conservatively without surgery.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
Dewey Decimal Classification:610 Medicine & health
Date:2008
Deposited On:05 Feb 2009 08:43
Last Modified:05 Apr 2016 12:57
Publisher:Lippincott Wiliams & Wilkins
ISSN:1077-4114
Publisher DOI:10.1097/MPH.0b013e318168e7cb
PubMed ID:18525466
Permanent URL: http://doi.org/10.5167/uzh-12446

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