title: The surgical management of abdominal pain in the multiple myeloma patient.
abstract: BACKGROUND
  The purpose of this retrospective study was to characterize the presentation, treatment, and outcomes of patients with multiple myeloma requiring surgical evaluation for abdominal pain.
  
  
  METHODS
  Medical records of patients with myeloma and abdominal pain evaluated by surgery over a period of 18 months were examined.
  
  
  RESULTS
  Twenty-one patients underwent surgical evaluation, with 23 diagnoses. Neutropenic enterocolitis (n = 5 [22%]) and ileus (n = 4 [17%]) were common diagnoses. Eleven patients (52%) were neutropenic. Peritonitis was noted in only 1 patient. Eastern Cooperative Oncology Group performance status was either 3 or 4 in most patients (67%). Surgery was performed in 5 patients. The 90-day mortality rate for all patients was 43%, with all deaths secondary to sepsis in patients managed without surgery.
  
  
  CONCLUSIONS
  Patients with myeloma requiring surgical evaluation for abdominal pain have a unique differential diagnosis, with notable findings at presentation including the presence of cytopenia, lack of peritoneal signs, and low performance status.
authors.affiliation: Department of Surgery, The University of Arkansas for Medical Sciences, Winthrop P. Rockefeller Cancer Institute, Little Rock, USA.
authors.forename: Jared
authors.initials: J
authors.lastname: Garrett
authors.forename: V Suzanne
authors.initials: VS
authors.lastname: Klimberg
authors.forename: Elias
authors.initials: E
authors.lastname: Anaissie
authors.forename: Bart
authors.initials: B
authors.lastname: Barlogie
authors.forename: Richard
authors.initials: R
authors.lastname: Turnage
authors.forename: Brian D
authors.initials: BD
authors.lastname: Badgwell
mesh_terms: D015746:Abdominal Pain / Q000209:etiology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D044504:Enterocolitis, Neutropenic / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D045823:Ileus / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D053208:Kaplan-Meier Estimate; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000401:mortality / Q000601:surgery; D010351:Patient Discharge / Q000706:statistics & numerical data; D010360:Patient Transfer / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016896:Treatment Outcome