title: Acute perforative appendicitis during preoperative chemotherapy for Wilms tumor.
abstract: Infectious complications are not uncommon in children undergoing treatment for cancer. Abdominal pain, especially right lower quadrant pain secondary to appendiceal and cecal inflammation, is a major concern in immunocompromised hosts and a potential source of sepsis. The authors report the case of a child who developed acute perforative appendicitis requiring appendectomy while on preoperative chemotherapy for Wilms tumor, stage IV, favorable histology. Problems related to diagnosis and management of acute abdominal pain and infection in an immunocompromised child with an abdominal mass are discussed along with a review of the literature.
authors.affiliation: Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, Department of Hematology/Oncology, New Orleans, Louisiana 70118, USA. mvelez@lsuhsc.edu
authors.forename: Maria C
authors.initials: MC
authors.lastname: Velez
authors.forename: Uma H
authors.initials: UH
authors.lastname: Athale
authors.forename: William
authors.initials: W
authors.lastname: Loe
authors.forename: R P
authors.initials: RP
authors.lastname: Warrier
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000208:Acute Disease; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001064:Appendicitis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D002442:Ceftazidime / Q000627:therapeutic use; D002648:Child; D003131:Combined Modality Therapy; D003609:Dactinomycin / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D004630:Emergencies; D005839:Gentamicins / Q000627:therapeutic use; D006801:Humans; D016867:Immunocompromised Host; D007416:Intestinal Perforation / Q000175:diagnosis / Q000209:etiology*; D007680:Kidney Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D020360:Neoadjuvant Therapy; D009392:Nephrectomy; D012422:Rupture, Spontaneous; D014750:Vincristine / Q000008:administration & dosage; D009396:Wilms Tumor / Q000150:complications* / Q000188:drug therapy / Q000601:surgery
chemical_list: D005839:Gentamicins; D008795:Metronidazole; D003609:Dactinomycin; D014750:Vincristine; D004317:Doxorubicin; D002442:Ceftazidime