Acute lymphoblastic leukemia presenting with typhlitis

Abstract

We report an unusual case of acute lymphoblastic leukemia (ALL) that presented as right lower quadrant pain in a 17‐year‐old boy. Ultrasonographic findings were consistent with typhlitis. The clinical and imaging symptoms resolved upon treatment with antibiotics and conservative care, only to recur after initiation of chemotherapy. Familiarity with the clinical presentation and imaging findings of typhlitis is important for its correct diagnosis and management. Med. Pediatr. Oncol. 28:209–212 © 1997 Wiley‐Liss, Inc.

Typhlitis in childhood cancer

“…[12][13][14] However, there has been no systematic evaluation of the optimal imaging modality for the diagnosis and/or management of typhlitis in children treated for cancer. [15][16][17][18][19][20] In our retrospective study, we investigated whether im-aging findings, clinical findings, and demographic factors are associated with the outcome of typhlitis. A secondary objective of our study was to determine whether demographic variables or previous drug therapy are associated with the risk of typhlitis in these children.…”

Neutropenic enterocolitis: A rare presenting complication of acute leukemia

“…The process has been recognized in numerous other settings with neutropenia or immunosuppression as well [6,[13][14][15][16][17][18]. Neutropenic enterocolitis can also be a rare presenting complication of acute leukemia, as in the case presented here and in three previous reports [4,19,20]. The management of this select group of patients presents significant diagnostic and treatment challenges.…”

“…In two cases treatment consisted of intensive sup- portive care with rapid deterioration precluding surgical intervention or chemotherapy. In Case 3 a less acute presentation and recurrent episodes of abdominal pain were successfully managed with conservative care, and the patient was reported alive and in remission 150 days after bone marrow transplant [19]. In the case presented here the patient succumbed to post-operative complications.…”

“…Neutropenic enterocolitis has been reported to occur prior to the initiation of chemotherapy in two cases of acute lymphoblastic leukemia and one case of acute myelogenous leukemia [4,19,20]. The case we describe illustrates the diagnostic and treatment challenges encountered when necrotizing enterocolitis is the presenting manifestation of acute lymphoblastic leukemia.…”

Surgical Complications of Childhood Tumors

“…Established cellulitis may progress to necrotizing fasciitis. Th e common forms of this disease are either [42] Ruptured liver tumor Appendicular carcinoid, lymphoma Intussusception Hemangioma [12,14] Ganglioneurofi broma [96] Lymphoma [26,115] Intestinal obstruction Leiomyoma [109] Esophageal leiomyoma [11] Intestinal fi bromatosis [17] Lymphoma Gastrointestinal bleeding Gastric teratoma [47] Typhlitis [48] Perianal abscess Yolk sac tumors Rhabdomyosarcoma Biliary obstruction Hemangioendothelioma [106] Rhabdomyosarcoma [16] Hydronephrosis Neuroblastoma and other pelvic tumors [40] Testicular swelling Primary tumor Leukemia [85] Lymphoma Varicocele Wilms' tumor 7…”