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Acute abdomen in childhood leukemia
1Department of Pediatrics, National Taiwan University Hospital, College of Medicine, Taipei, R.O.C.
Journal of the Formosan Medical Association = Taiwan Yi Zhi
|January 1, 1990
Summary
Childhood leukemia patients surviving longer face increased abdominal complications, often linked to chemotherapy and low blood counts. Early surgical intervention improves survival rates for these critical cases.
Area of Science:
- Pediatric Oncology
- Gastroenterology
- Hematology
Background:
- Advancements in childhood leukemia treatment have led to increased patient survival.
- Longer survival is associated with a higher incidence of abdominal complications.
Purpose of the Study:
- To analyze the incidence and characteristics of abdominal complications in pediatric leukemia patients.
- To evaluate the impact of treatment, including surgery, on patient outcomes.
Main Methods:
- Retrospective analysis of 364 leukemia patients treated between January 1977 and April 1988.
- Detailed review of cases with documented abdominal complications.
Main Results:
- 11 patients (3.0%) developed abdominal complications, often during leukemia presentation or relapse, frequently post-chemotherapy.
- Common complications included appendicitis, intussusception, and intestinal perforation, frequently associated with thrombocytopenia and leukopenia.
- Septicemic patients (45%) often had gram-negative enteric bacilli and leukopenia/neutropenia; manifestations were nonspecific.
- Surgical intervention in 7 patients correlated with better long-term survival compared to non-operative management.
Conclusions:
- Abdominal complications are a significant concern in surviving childhood leukemia patients, particularly those undergoing chemotherapy.
- Nonspecific symptoms and masked presentations necessitate high clinical suspicion.
- Prompt diagnosis and aggressive management, including surgical intervention when indicated, are crucial for improving outcomes.