Non-resection management of intestinal perforation associated with neutropenic enterocolitis in adolescent leukemia
Background: Neutropenic enterocolitis (NE) is a necrotizing inflammatory disease of the cecum or colon that develops during severe neutropenia. We present a leukemic patient who developed multiple intestinal perforations associated with NE and recovered by surgical intervention without bowel resecti...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | Journal of Pediatric Surgery Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213576622003360 |
| _version_ | 1811296545801240576 |
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| author | Shiho Yoshida Miki Toma Keisuke Kato Toshihiro Yanai |
| author_facet | Shiho Yoshida Miki Toma Keisuke Kato Toshihiro Yanai |
| author_sort | Shiho Yoshida |
| collection | DOAJ |
| description | Background: Neutropenic enterocolitis (NE) is a necrotizing inflammatory disease of the cecum or colon that develops during severe neutropenia. We present a leukemic patient who developed multiple intestinal perforations associated with NE and recovered by surgical intervention without bowel resection. Case presentation: A 16-year-old girl was diagnosed with acute lymphoblastic leukemia. During induction therapy, she had been developing severe neutropenia and started to complain of abdominal pain. On day 36, she was experiencing severe abdominal pain with distention, and computed tomography showed abdominal free air and the thickened cecum wall. Emergency surgery revealed multiple perforations on the cecum with patchy necrosis. Abdominal drainage by tube-cecostomy and ileostomy were performed, and the patient gradually recovered. Two months later, the affected cecum was found recovered on second surgery, the ileostomy was closed, and the cecostomy was removed. Eight months after the first surgery, the patient was discharged after maintenance therapy. Conclusions: NE must be suspected in neutropenic patients with abdominal pain. In cases presenting severe complications such as intestinal perforation, abdominal drainage with ostomy can be a promising and minimally invasive option which may contribute to the bowel salvage and avoiding unnecessary bowel resection. |
| first_indexed | 2024-04-13T05:50:04Z |
| format | Article |
| id | doaj.art-0c9dc5c6677a48199311d57421f3c613 |
| institution | Directory Open Access Journal |
| issn | 2213-5766 |
| language | English |
| last_indexed | 2024-04-13T05:50:04Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Pediatric Surgery Case Reports |
| spelling | doaj.art-0c9dc5c6677a48199311d57421f3c6132022-12-22T02:59:48ZengElsevierJournal of Pediatric Surgery Case Reports2213-57662023-01-0188102509Non-resection management of intestinal perforation associated with neutropenic enterocolitis in adolescent leukemiaShiho Yoshida0Miki Toma1Keisuke Kato2Toshihiro Yanai3Department of Pediatric Surgery, Ibaraki Children's Hospital, Mito, Ibaraki, Japan; Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, JapanDepartment of Pediatric Surgery, Ibaraki Children's Hospital, Mito, Ibaraki, Japan; Corresponding author. Department of Pediatric Surgery, Ibaraki Children's Hospital, 3-3-1, Futabadai, Mito, Ibaraki, 311-4145, Japan.Division of Pediatric Hematology and Oncology, Ibaraki Children's Hospital, Mito, Ibaraki, JapanDepartment of Pediatric Surgery, Ibaraki Children's Hospital, Mito, Ibaraki, JapanBackground: Neutropenic enterocolitis (NE) is a necrotizing inflammatory disease of the cecum or colon that develops during severe neutropenia. We present a leukemic patient who developed multiple intestinal perforations associated with NE and recovered by surgical intervention without bowel resection. Case presentation: A 16-year-old girl was diagnosed with acute lymphoblastic leukemia. During induction therapy, she had been developing severe neutropenia and started to complain of abdominal pain. On day 36, she was experiencing severe abdominal pain with distention, and computed tomography showed abdominal free air and the thickened cecum wall. Emergency surgery revealed multiple perforations on the cecum with patchy necrosis. Abdominal drainage by tube-cecostomy and ileostomy were performed, and the patient gradually recovered. Two months later, the affected cecum was found recovered on second surgery, the ileostomy was closed, and the cecostomy was removed. Eight months after the first surgery, the patient was discharged after maintenance therapy. Conclusions: NE must be suspected in neutropenic patients with abdominal pain. In cases presenting severe complications such as intestinal perforation, abdominal drainage with ostomy can be a promising and minimally invasive option which may contribute to the bowel salvage and avoiding unnecessary bowel resection.http://www.sciencedirect.com/science/article/pii/S2213576622003360Neutropenic enterocolitisAcute lymphoblastic leukemiaIntestinal perforation |
| spellingShingle | Shiho Yoshida Miki Toma Keisuke Kato Toshihiro Yanai Non-resection management of intestinal perforation associated with neutropenic enterocolitis in adolescent leukemia Journal of Pediatric Surgery Case Reports Neutropenic enterocolitis Acute lymphoblastic leukemia Intestinal perforation |
| title | Non-resection management of intestinal perforation associated with neutropenic enterocolitis in adolescent leukemia |
| title_full | Non-resection management of intestinal perforation associated with neutropenic enterocolitis in adolescent leukemia |
| title_fullStr | Non-resection management of intestinal perforation associated with neutropenic enterocolitis in adolescent leukemia |
| title_full_unstemmed | Non-resection management of intestinal perforation associated with neutropenic enterocolitis in adolescent leukemia |
| title_short | Non-resection management of intestinal perforation associated with neutropenic enterocolitis in adolescent leukemia |
| title_sort | non resection management of intestinal perforation associated with neutropenic enterocolitis in adolescent leukemia |
| topic | Neutropenic enterocolitis Acute lymphoblastic leukemia Intestinal perforation |
| url | http://www.sciencedirect.com/science/article/pii/S2213576622003360 |
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