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.
MeSH terms
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Abdominal Pain / etiology
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Acute Disease
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Antineoplastic Combined Chemotherapy Protocols / adverse effects
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
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Appendicitis / complications*
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Appendicitis / diagnosis
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Appendicitis / drug therapy
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Appendicitis / surgery
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Ceftazidime / therapeutic use
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Child
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Combined Modality Therapy
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Dactinomycin / administration & dosage
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Doxorubicin / administration & dosage
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Drug Therapy, Combination / therapeutic use
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Emergencies
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Gentamicins / therapeutic use
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Humans
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Immunocompromised Host
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Intestinal Perforation / diagnosis
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Intestinal Perforation / etiology*
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Kidney Neoplasms / complications*
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Kidney Neoplasms / drug therapy
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Kidney Neoplasms / surgery
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Male
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Metronidazole / therapeutic use
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Neoadjuvant Therapy*
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Nephrectomy
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Rupture, Spontaneous
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Vincristine / administration & dosage
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Wilms Tumor / complications*
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Wilms Tumor / drug therapy
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Wilms Tumor / surgery
Substances
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Gentamicins
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Metronidazole
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Dactinomycin
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Vincristine
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Doxorubicin
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Ceftazidime