ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Surgery
This article is part of the Research TopicApplication of Minimally Invasive Techniques in Gastrointestinal Diseases in ChildrenView all 5 articles
Conservative versus Surgical Management of Acute Appendicitis in Children with Acute Leukemia: A Single-Center Retrospective Case Series
Provisionally accepted
- 1Department of Pediatric Surgery, Children's Hospital Affiliated to Shandong University, Jinan, China
- 2Children's Hospital Affiliated to Shandong University, Jinan, China
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Objective: 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. Methods: 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. Results: Among the 10 children in this study, appendicitis onset occurred during induction (n=5), consolidation (n=2), or maintenance (n=3) 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. Conclusion: 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.
Keywords: acute appendicitis in children, Acute leukemia, Multidisciplinary collaboration, Perioperative management, Transumbilical single-site double-port laparoscopic appendectomy
Received: 11 Oct 2025; Accepted: 19 Dec 2025.
Copyright: © 2025 Liu, Shi, Jia, Liu and Kong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Hongzhen Liu
Meng Kong
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