Isolated Appendiceal Typhlitis Masquerading As Perforated Appendicitis in the Setting of Acute Lymphoblastic Leukemia

Overview

Journal Pediatr Surg Int

Specialties General Surgery
Pediatrics

Date 2014 Jan 23

PMID 24448913

Citations 3

Authors

Jarod P McAteer

Sabrina E Sanchez

Joe C Rutledge

John H T Waldhausen

Affiliations

Soon will be listed here.

Abstract

Abdominal pain is common during chemotherapy for childhood leukemia. Clinically differentiating typhlitis from appendicitis can be difficult. We present an 8-year-old boy with abdominal pain in the setting of acute lymphoblastic leukemia and neutropenia. Following appendectomy for presumed appendicitis, pathology revealed appendiceal typhlitis. Diagnostic and treatment considerations are discussed.

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References

Mullassery D, Bader A, Battersby A, Mohammad Z, Jones E, Parmar C . Diagnosis, incidence, and outcomes of suspected typhlitis in oncology patients--experience in a tertiary pediatric surgical center in the United Kingdom. J Pediatr Surg. 2009; 44(2):381-5. DOI: 10.1016/j.jpedsurg.2008.10.094. View

Katz J, Wagner M, Gresik M, Mahoney Jr D, Fernbach D . Typhlitis. An 18-year experience and postmortem review. Cancer. 1990; 65(4):1041-7. DOI: 10.1002/1097-0142(19900215)65:4<1041::aid-cncr2820650433>3.0.co;2-a. View

Hsiao P, Kuo S, Chen J, Lin H, Chu P, Lin S . Acute myelogenous leukemia and acute leukemic appendicitis: a case report. World J Gastroenterol. 2009; 15(44):5624-5. PMC: 2785068. DOI: 10.3748/wjg.15.5624. View

Angel C, Rao B, Wrenn Jr E, Lobe T, Kumar A . Acute appendicitis in children with leukemia and other malignancies: still a diagnostic dilemma. J Pediatr Surg. 1992; 27(4):476-9. DOI: 10.1016/0022-3468(92)90342-5. View

Fike F, Mortellaro V, Juang D, St Peter S, Andrews W, Snyder C . Neutropenic colitis in children. J Surg Res. 2011; 170(1):73-6. DOI: 10.1016/j.jss.2011.01.041. View

Toubai T, Kondo Y, Ogawa T, Imai A, Kobayashi N, Ogasawara M . A case of leukemia of the appendix presenting as acute appendicitis. Acta Haematol. 2003; 109(4):199-201. DOI: 10.1159/000070971. View

Altinbas A, Eken G, Cetiner D, Koca E, Dundar Z, Haznedaroglu I . Typhilitis of the appendix presenting as an acute appendicitis in acute myeloid leukemia. Am Surg. 2011; 77(2):231. View

Skibber J, Matter G, Pizzo P, Lotze M . Right lower quadrant pain in young patients with leukemia. A surgical perspective. Ann Surg. 1987; 206(6):711-6. PMC: 1493312. DOI: 10.1097/00000658-198712000-00005. View

SCHALLER Jr R, SCHALLER J . The acute abdomen in the immunologically compromised child. J Pediatr Surg. 1983; 18(6):937-44. DOI: 10.1016/s0022-3468(83)80050-5. View

10.

Muller G, Dargent J, Duwel V, DOlne D, Vanvuchelen J, Haot J . Leukaemia and lymphoma of the appendix presenting as acute appendicitis or acute abdomen. Four case reports with a review of the literature. J Cancer Res Clin Oncol. 1997; 123(10):560-4. DOI: 10.1007/s004320050105. View

11.

Merine D, Fishman E, Jones B, Nussbaum A, Simmons T . Right lower quadrant pain in the immunocompromised patient: CT findings in 10 cases. AJR Am J Roentgenol. 1987; 149(6):1177-9. DOI: 10.2214/ajr.149.6.1177. View

12.

Turrini O, Moutardier V, Vey N, Guiramand J, Lelong B, Delpero J . Sometimes appendicitis can wait. Am J Hematol. 2004; 76(3):312-3. DOI: 10.1002/ajh.20086. View

13.

Shamberger R, Weinstein H, Delorey M, Levey R . The medical and surgical management of typhlitis in children with acute nonlymphocytic (myelogenous) leukemia. Cancer. 1986; 57(3):603-9. DOI: 10.1002/1097-0142(19860201)57:3<603::aid-cncr2820570335>3.0.co;2-k. View

14.

McCarville M, Thompson J, Li C, Adelman C, Lee M, Alsammarae D . Significance of appendiceal thickening in association with typhlitis in pediatric oncology patients. Pediatr Radiol. 2004; 34(3):245-9. DOI: 10.1007/s00247-003-1122-3. View

15.

Carr N . The pathology of acute appendicitis. Ann Diagn Pathol. 2000; 4(1):46-58. DOI: 10.1016/s1092-9134(00)90011-x. View