Appendicitis in leukemia and aplastic anemia: neutropenia not a contraindication to surgery

Abstract

The management of the neutropenic child with abdominal pain can be difficult. It has been suggested that the clinical findings are unreliable in assessing the need for surgical intervention. This retrospective study of ten neutropenic children who underwent emergent appendectomy at this institution over the past 21 years suggests that careful clinical evaluation is essential in planning therapy. Pain was a universal complaint and was associated with fever in 70% of patients. Clinical assessment was correct in 80% of this group, whose mean absolute neutrophil count was 0.59±0.36 (mean ± SD) at the time of presentation. All patients survived surgery and mean hospitalization was 12.8±5.3 days. We conclude that appendectomy can be performed safely in the presence of neutropenia.