The acute abdomen in the immunologically compromised child

Area of Science:

• Pediatric Surgery
• Pediatric Oncology
• Gastroenterology

Background:

• Children with leukemia, aplastic anemia, and solid tumors are susceptible to acute abdominal disease.
• Cancer treatments like chemotherapy and irradiation can alter immune and hematopoietic systems, increasing abdominal complication risks.

Purpose of the Study:

• To evaluate the incidence and outcomes of acute abdominal disease in pediatric cancer patients.
• To highlight the spectrum of surgical emergencies encountered in this population.

Main Methods:

• Retrospective review of 35 pediatric patients (1976-1982) with leukemia, aplastic anemia, or solid tumors.
• Analysis of symptoms, signs, surgical interventions, and outcomes related to acute abdominal disease.

Main Results:

• 26 patients (74%) required 34 operations, 14 for life-threatening events.
• Common surgical emergencies included gastrointestinal hemorrhage, biliary tract disease, and typhlitis.
• 13 patients (37%) survived, while 22 (63%) died, 13 due to abdominal complications.

Conclusions:

• Acute abdominal complications are a significant cause of morbidity and mortality in pediatric cancer patients.
• Early, aggressive surgical intervention is essential for improving survival rates.
• Surgeons must be aware of the diverse abdominal complications in this patient group.