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Management of Acute Appendicitis in Special Pediatric Situations: Malignancy, Neutropenia, and Other Etiologies of Immune Suppression

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Controversies in Pediatric Appendicitis

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Abstract

The diagnosis and management of acute appendicitis in children with neutropenia secondary to chemotherapy or other causes of immune deficiency are challenging. These children are at risk for severe infectious complications without definitive source control but may also be at heightened risk for surgical complications. Reported data from institutional case series support the safety and efficacy of both up-front appendectomy and broad-spectrum antibiotic therapy with or without delayed appendectomy. Further research is required to determine the optimal treatment approach for this challenging group of patients.

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Notes

  1. 1.

    These hospitals are affiliated with the Children’s Hospital Association (CHA) (Lenexa, KS). Data quality and reliability are assured through a joint effort between the CHA and participating hospitals. Portions of the data submission and data quality processes for the PHIS data set are managed by Truven Health Analytics (Ann Arbor, MI). For the purposes of external benchmarking, participating hospitals provide discharge/encounter data including demographics, diagnoses, and procedures. Nearly all of these hospitals also submit resource utilization data into PHIS. Data are de-identified at the time of data submission, and data are subjected to a number of reliability and validity checks before being included in the dataset.

  2. 2.

    ICD-9 and ICD-10 codes

    • Acute appendicitis (K350, K352, K353, K3580, K3589, 540, 5400, 54009, 5401, or 5409).

    • Chemotherapy-induced neutropenia or pancytopenia (D701, D61810, 28411, or 28803).

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Authors and Affiliations

  1. Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Timothy B. Lautz

  2. Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA

    Timothy B. Lautz

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  1. Timothy B. Lautz
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Correspondence to Timothy B. Lautz .

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Editors and Affiliations

  1. Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Catherine J. Hunter

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Lautz, T.B. (2019). Management of Acute Appendicitis in Special Pediatric Situations: Malignancy, Neutropenia, and Other Etiologies of Immune Suppression. In: Hunter, C. (eds) Controversies in Pediatric Appendicitis. Springer, Cham. https://doi.org/10.1007/978-3-030-15006-8_16

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  • DOI: https://doi.org/10.1007/978-3-030-15006-8_16

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-15005-1

  • Online ISBN: 978-3-030-15006-8

  • eBook Packages: MedicineMedicine (R0)

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