A Case of Neutropenic enterocolitis and Acute Appendicitis which Occured in the Myelosuppressive Stage during the Induction Therapy of Acute Myelocytic Leukemia

Masahito Kotaka, Masanori Sugito, Akihiro Kobayasi, Takaya Kobatake, Masaaki Yano and Norio Saito

Colorectal and Pelvic Surgery Division, National Cancer Center Hospital East

We report a case of neutropenic enterocolitis and acute appendicitis occurring in the myelosuppressive stage during induction therapy for acute myelocytic leukemia. A 42-year-old man with high fever and subcutaneous bleeding and diagnosed with acute myelocytic leaukemia (M0) had right lower duadrant pain after 17 days of chemotherapy for AML. He was diagnosed with neutropenic enterocolitis based on abdominal computed tomography (CT) showing wall thickening and inflammatory change from the cecum to the ascending colon. Conservative therapy adoped based on abdominal findings and the myelosuppressive stage relieved abdominal symptoms, but he was diagnosed with acute appendicitis when colonoscopy showed pus discharge from the appendical orifice. Histological findings from appendectomy showed acute-chronic inflammation but no leukemic cells. In the future, there is highly possibility that we will encounter the patient having acute abdomen during leukemia treatment.

Key words
leukemia, acute abdomen, neutropenic enterocolitis

Reprint requests
Masahito Kotaka Colorectal and Pelvic Surgery Division, National Cancer Center Hospital East
6-5-1 Kashiwanoha, Kashiwa, 277-8577 JAPAN

Accepted
May 31, 2006

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