Department of Surgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Yonsei Med J. 2012 Jul 1;53(4):781-7. doi: 10.3349/ymj.2012.53.4.781.
Acute appendicitis has been reported to be relatively rare in pediatric leukemia patients but there is no official data for this in Korea. And there is no consensus for its treatment in this population.
We conducted a retrospective study of 7 patients diagnosed with appendicitis among 1209 pediatric patients who were diagnosed with leukemia from 1996 to 2008 at a single institution in Korea.
The median age at the time of the diagnosis of appendicitis was 12 years (range: 3-15 years), and 3 of the patients were male. The median absolute neutrophil count (ANC) at the time of diagnosis was 0.99×10⁹/L (range: 0-3×10⁹/L). The mean time from the onset of symptoms to the diagnosis was 4 days. All 7 leukemia patients with appendicitis underwent surgery and they demonstrated a survival of 100% without significant complications.
The incidence of appendicitis in pediatric leukemia patients was 0.57% in our study. Early diagnosis with abdominal ultrasound or computed tomography and early surgical resection in leukemic patient with acute appendicitis may be a safer and more effective treatment option. Even when perforation has already occurred and when the patient has an ANC of 0×10⁹/L, surgical treatment may improve overall survival without incurring significant complications.
据报道，儿科白血病患者的急性阑尾炎相对少见，但韩国尚无此类疾病的官方数据。对于该人群，其治疗方法尚无共识。
我们对 1996 年至 2008 年在韩国一家机构确诊的 1209 例儿科白血病患者中诊断为阑尾炎的 7 例患者进行了回顾性研究。
阑尾炎诊断时的中位年龄为 12 岁（范围：3-15 岁），其中 3 例为男性。诊断时的绝对中性粒细胞计数（ANC）中位数为 0.99×10⁹/L（范围：0-3×10⁹/L）。症状出现至诊断的平均时间为 4 天。所有 7 例患有阑尾炎的白血病患者均接受了手术治疗，且无明显并发症，100%生存。
在本研究中，儿科白血病患者阑尾炎的发病率为 0.57%。对于患有急性阑尾炎的白血病患者，早期进行腹部超声或计算机断层扫描检查，并早期进行手术切除，可能是一种更安全、更有效的治疗选择。即使已经穿孔，ANC 为 0×10⁹/L，手术治疗也可能提高总体生存率，而不会产生明显的并发症。
