{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T03:20:08Z","timestamp":1788232808099,"version":"build-2803163510"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007129","name":"Natural Science Foundation of Shandong Province","doi-asserted-by":"publisher","award":["ZR2022MH229"],"award-info":[{"award-number":["ZR2022MH229"]}],"id":[{"id":"10.13039\/501100007129","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To explore the diagnostic challenges, individualized treatment strategies, and prognostic outcomes of acute appendicitis in children with acute leukemia and to provide practical evidence and clinical guidance for establishing a standardized multidisciplinary collaborative diagnosis and treatment protocol.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center retrospective case series analyzed the clinical data of children with acute leukemia complicated by acute appendicitis admitted between December 2020 and December 2024. All children were evaluated by a multidisciplinary team (MDT). Individualized treatment plans, including either conservative management or surgical appendectomy, were formulated based on MDT assessment. Clinical data were analyzed retrospectively to summarize diagnostic and therapeutic experience.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 10 children in this study, appendicitis onset occurred during induction (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20095), consolidation (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092), or maintenance (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093) chemotherapy. Seven children with uncomplicated appendicitis were successfully treated conservatively with anti-infective and hematopoietic support. The remaining three children, presenting with fecalith impaction or perforation, underwent emergency transumbilical single-site double-port laparoscopic appendectomy (TSSDPLA); pathology confirmed suppurative or gangrenous appendicitis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This small case series highlights that managing acute appendicitis in leukemic children requires individualized MDT-guided strategies. Conservative treatment was effective for uncomplicated cases, while TSSDPLA provided a feasible minimally invasive option for complications. Early resumption of chemotherapy was prioritized. All patients achieved infection control and continued leukemia therapy without mortality. These findings offer a preliminary management framework, pending validation in larger studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2025.1722697","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T08:18:04Z","timestamp":1768205884000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Conservative vs. surgical management of acute appendicitis in children with acute leukemia: a single-center retrospective case 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