{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T08:11:10Z","timestamp":1794039070762,"version":"4.8.0"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T00:00:00Z","timestamp":1623196800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T00:00:00Z","timestamp":1623196800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"No funding"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Acute appendicitis is a rare gastrointestinal complication of anti-cancer chemotherapy and hematopoietic stem cell transplantation. Among a cohort of 2341 hemato-oncologic patients at a pediatric tertiary care cancer center, we identified 21 patients (0.9%) with 23 episodes of acute appendicitis, based on pathological imaging of the appendix and clinical findings. Median age at diagnosis was 10.21\u00a0years. Types of underlying disease included acute leukemias (n\u2009=\u200915), solid tumors (n\u2009=\u20094), and aplastic anemia (n\u2009=\u20092). Clinical symptoms seen in\u2009&gt;\u20091 case were recorded for all 23 episodes as follows: abdominal pain, n\u2009=\u200922; abdominal tenderness, n\u2009=\u20094; fever, n\u2009=\u20097; nausea, n\u2009=\u20092; emesis; n\u2009=\u20092; diarrhea, n\u2009=\u20095; and constipation, n\u2009=\u20092. Median leukocyte count at diagnosis was 0.5\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L, with a median of 0.1\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L for the absolute neutrophil count (ANC). All patients received broad-spectrum antibiotics and 18\/23 (78%) patients underwent uneventful appendectomy after a median of 5\u00a0days and with a median ANC of 0.7\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L. Median duration until continuation of chemotherapy was 17\u00a0days for the 20 cases of appendicitis occurring during the patients\u2019 disease course. Overall, 5\/21 (19%) patients died including one related to the appendicitis itself which progressed to a typhlitis and was due to a fungal infection. The other fatalities were transplant- (n\u2009=\u20092) and leukemia-related (n\u2009=\u20092). Acute appendicitis is a rare and usually not life-threatening event in pediatric hemato-oncologic patients, which, if managed by prompt administration of broad-spectrum antibiotics (and antimycotics), can be safely followed by an elective (delayed) appendectomy, even before complete recovery of the neutrophils is achieved.<\/jats:p>","DOI":"10.1038\/s41598-021-90206-6","type":"journal-article","created":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T10:16:45Z","timestamp":1623233805000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Diagnosis and management of acute appendicitis in 21 pediatric hematology and oncology patients at a tertiary care cancer center"],"prefix":"10.1038","volume":"11","author":[{"given":"Hannah","family":"von Mersi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Benk\u00f6","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidrun","family":"Boztug","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Dworzak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gernot","family":"Engstler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waltraud","family":"Friesenbichler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Hutter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karoly","family":"Lakatos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Mann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Metzelder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roswitha","family":"L\u00fcftinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herbert","family":"Pichler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona","family":"Poyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila","family":"Ronceray","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9285-6898","authenticated-orcid":false,"given":"Andishe","family":"Attarbaschi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,6,9]]},"reference":[{"key":"90206_CR1","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1016\/j.jpedsurg.2004.09.048","volume":"40","author":"MJ Hobson","year":"2005","unstructured":"Hobson, M. 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