Two Cases of Acute Celiopathy which Occurred in the Bone Marrow lnhibition Stage during the Treatment of Leukemia and Performed Surgical Treatment

Kenichi Sakamoto, Takahiko Fukuchi*

Department of Surgrey, Municipal Kisogawa Hospital
*First Department of Surgery, Gifu University School of Medicine

It is difficult to determine whether to perform surgical treatment or not in the patient with acute celiopathy complicating a hematopoietic organ tumor in the bone marrow inhibition stage. We performed surgical treatment in 2 leukemia cases during the bone marrow inhibition stage.Diverticulitis of the large intestine occurred in one patient and acute appendicitis in the other. We present these two cases. Case 1 was that of a 46-year-old female.The blood data of this patient were WBC 2,000/mm³ (neutrophils l%) and right hemi-colectomy was performed. Perforating pseudodiverticula of the ascending colon were observed. Case 2 was that of a 68-year-old female. The blood data were WBC 400/mm³ (neutrophils 0%) and appendectomy was performed. It was acute appendicitis accompained by marked degenerative inflammation. In both cases the surgery and post-surgical controls were carried out in a clean room. After surgry without hemorrhage and wound infection it was possible to resume the treatment for leukemia, so the surgery was considered effective. Regardless of the stage of the underlying disease and even in the bone marrow inhibition stage, it was suggested that the positive indications for surgery could improve the therapeutic effect on the underlying disease if performed under careful control during and after the surgery.

Key words
leukemia in the bone marrow inhibition stage, acute celiopathy, surgery

Reprint requests
Kenichi Sakamoto Department of Surgery I, Gifu University School of Medicine
40 Tsukasa-machi, Gifu, 500 JAPAN

Accepted
December 6, 1995

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