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Management of the acute abdomen in children with leukemia
Insights
Acute abdomen is a growing concern in childhood leukemia care. Aggressive surgical management and chemotherapy can improve long-term survival rates for these young patients.
Area of Science:
- Pediatric Oncology
- Surgical Gastroenterology
Background:
- Increased remission and survival rates in childhood acute leukemia have highlighted the importance of managing complications like acute abdomen.
- Acute abdomen presents a significant challenge in the comprehensive care of pediatric leukemia patients.
Purpose of the Study:
- To evaluate the incidence and outcomes of acute abdomen in children with acute leukemia.
- To determine the impact of surgical intervention and chemotherapy on long-term survival in these cases.
Main Methods:
- Retrospective review of 286 children with acute leukemia treated between 1966 and 1971.
- Analysis of 16 cases diagnosed with acute abdomen, including surgical and conservative management approaches.
Main Results:
- 16.6% of children with acute leukemia developed acute abdomen.
- Surgical intervention in 9 patients resulted in 5 long-term survivors.
- Prognosis was improved with surgical remission and continued antileukemic chemotherapy.
Conclusions:
- An aggressive surgical approach to acute abdomen in pediatric leukemia, coupled with supportive care and prompt chemotherapy, enhances long-term survival.
- Management of acute abdomen is crucial for improving outcomes in childhood leukemia survivors.
Abstract:
With the increase in remission and survival in children with acute leukemia, the complication of acute abdomen has become increasingly important in the total care of these children. A total of 286 children with acute leukemia was treated at Memorial Hospital between 1966 and 1971. Sixteen or 5.6% of these children developed an acute abdomen during the course of their disease. During the same period, many other children developed symptoms and signs mimicking an acute abdomen. Of the 9 children treated surgically, 5 were long-term survivors. Two children treated conservatively died, and 5 patients were diagnosed at autopsy. Prognosis was better in those patients in remission at the time of surgery, and where remission was maintained by immediately restarting antileukemic chemotherapy. A more aggressive surgical approach to the acute abdomen, combined with careful supportive measures, is further adding to the numbers of long-term survivors in childhood leukemia.