Acute Appendicitis in Patients with Leukemia: A Dilemma in Diagnosis and Surgical Treatment

Chen Wang, Han-Zhang Huang, Yu-Jun Yu, Yu He and Shao-Liang Han

Department of General Surgery, Wenzhou Medical University, China

^*Correspondance to: Shao-Liang Han 

 PDF  Full Text DOI: 10.25107/2474-1647.2433

Abstract

Acute appendicitis in patients with leukemia is rare, which mainly complicates leukemic involvement of appendix or associates with cases of relapse of the disease. Therefore, it is a challenge to make correct diagnosis and treatment of appendicitis. The clinical and surgical data of 23 leukemia patients with acute appendicitis were analyzed retrospectively. There were 15 male and 8 female, with median age of 25.6 years old (ranging: 15 to 44 years). The underlying disease was 5 acute leukemia and 18 chronic leukemia. The main symptoms were abdominal pain (100%), fever (87.0%), vomiting (44.4%), diarrhea (13.0%) and abdominal distension (21.7%). The median WBC count <2 × 109/L at the time of diagnosis was in one case, between 1 to 2 × 109/L in 4, <5 × 109/L in 4; and the median platelet count <20 × 109/L was in one case, <50 × 109/L in 8, and >50 × 109/L in 14; Hb>60 g/L was in 17 cases, and <60g/L in 6. All 23 patients received surgery, 17 with open appendectomy and 6 with laparoscopic appendectomy. A high index of suspicion must be kept when leukemia patients have right lower quadrant abdominal pain, and an early surgery is an effective treatment option for leukemia patients with appendicitis.

Keywords

Appendicitis; Leukemia; Neutropenia; Appendectomy

Cite the article

Wang C, Huang H-Z, Yu Y-J, He Y, Han S-L. Acute Appendicitis in Patients with Leukemia: A Dilemma in Diagnosis and Surgical Treatment. Clin Surg. 2019; 4: 2433.