[The medical and surgical management of acute abdominal complications in neutropenic cancer patient: description of 21 cases].
Because of the lack of specificity of gastrointestinal tract symptoms and of imaging studies findings in one hand, and because of a presumed high risk of complications in the other hand, surgical management of acute abdomen in neutropenic patients remains very controversial. The purpose of the study is to review our experience with management of acute abdomen. The records of 21 neutropenic patients admitted in the intensive care unit for postoperative management or for evaluation and diagnosis of abdominal symptoms were reviewed. Thirteen patients underwent surgery, 8 did not. Peritoneal signs on physical examination were correlated with positive laparotomies, the sensitivity was 71% and the specificity was 50%. Seven of the 13 operated patients survived the surgical procedure (54%); while 37,5% of the non operative group survived. The surgical treatment may be safely carried out in neutropenic patients with an acute abdomen and represent sometimes the only way to assure proper treatment.
Antoun
S
S
Service de réanimation, Institut Gustave-Roussy, Centre de lutte contre le cancer, rue Camille-Desmoulins, 94805 Villejuif Cedex.
Elias
D
D
Lasser
P
P
Bourhis
J H
JH
Treich
G
G
Blot
F
F
Nitenberg
G
G
D000006:Abdomen, Acute / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality / Q000601:surgery*; D009503:Neutropenia / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D010533:Peritoneal Lavage; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate