2023 Volume 60 Issue 5 Pages 371-376
The incidence of acute appendicitis during chemotherapy for pediatric cancer is low (0.3–1.5%) and there is no consensus on the criteria for selecting between operative and nonoperative treatment for its initial management. We retrospectively reviewed the stage of appendicitis, its treatment, and treatment outcomes in six cases in which acute appendicitis had developed during chemotherapy in our department. Five patients underwent nonoperative treatment and one underwent laparoscopic appendectomy as the initial treatment. There was a trend toward longer chemotherapy delays in the nonoperative treatment group. Two patients with nonoperatively treated phlegmonous appendicitis relapsed and underwent appendectomy. Chemotherapy delays of 27 and 37 days, respectively, were required in these two cases. One patient who underwent laparoscopic appendectomy as the initial treatment had a wound infection and pancreatitis, a possible complication of chemotherapy. However, the chemotherapy delay was only 5 days. These findings suggest that nonoperative treatment might not be an effective initial management in patients with phlegmonous appendicitis. Further studies with a large number of patients are needed to confirm these findings.
