Acute illnesses necessitating urgent abdominal surgery in neutropenic cancer patients: description of 14 cases and review of the literature.
Through a review of our experience and the literature, the cases of 56 neutropenic cancer patients requiring urgent abdominal surgery have been studied. The most common underlying diagnosis of malignant disease was leukemia (70%), and the most common intra-abdominal disease discovered at surgery was neutropenic enteropathy (61%). Major postoperative complications occurred in 50% of cases. The 30-day postoperative mortality was 32%, and the determinant 6-month survival was 34%. Abdominal pain in a neutropenic cancer patient calls for a thorough evaluation of its cause and careful serial examinations. Evidence of a surgically treatable disease or failure to respond to medical therapy for a presumed medically treatable disease should prompt surgical intervention.
Glenn
J
J
Surgery Branch, Clinical Oncology Program, National Cancer Institute, Bethesda, Md.
Funkhouser
W K
WK
Schneider
P S
PS
D000006:Abdomen, Acute / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000380:Agranulocytosis / Q000150:complications*; D000714:Anastomosis, Surgical / Q000009:adverse effects; D002648:Child; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy; D007938:Leukemia / Q000150:complications / Q000401:mortality / Q000601:surgery*; D008223:Lymphoma / Q000150:complications / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000150:complications* / Q000209:etiology / Q000401:mortality; D011183:Postoperative Complications / Q000209:etiology; D011379:Prognosis; D012189:Retrospective Studies; D013529:Surgical Wound Dehiscence / Q000209:etiology