Severe Necrotizing Perianal Cellulitis in a Child with Acute Lymphoblastic Leukemia that Developed After Rectal Enema Use

Yıl 2014, Cilt: 8 Sayı: 4, 215 - 218, 01.04.2014

Mustafa Çakan Barış Yılmaz , Sinem Daştan Adem Canan Kıvılcım Karadeniz Cerit Ahmet Koç

Öz

Rectal applications are not recommended in patients who receive chemotherapy for malignant hematological diseases as they can cause serious complications, especially during neutropenic periods. Minimal mucosal damage during a rectal application can lead to cellulitis, abscess formation and fi stulization. Our case is a 7-year-old boy who had been newly diagnosed with acute lymphoblastic leukemia. While he was undergoing induction therapy, rectal enema was administered at home because of two days of constipation after discharge from the hospital. The patient developed severe necrotizing perianal cellulitis and needed wide debridement, colostomy opening and autologous skin engraftment for treatment. We decided to present our case to once again emphasize the importance of this topic

Anahtar Kelimeler

Child, Leukemia, Neutropenia, Cellulitis

Akut Lenfoblastik Lösemili Çocukta Nötropenik Dönemde Rektal Lavman Uygulaması Sonucu Gelişen Ağır Nekrotizan Perianal Selülit

Öz

Hematolojik malignite nedeniyle kemoterapi alan hastalarda, özellikle nötropenik olduğu dönemlerde rektal uygulamalar ciddi komplikasyonlara yol açabileceği için önerilmemektedir. Uygulama sırasında anüs veya rektum mukozasında oluşabilecek minimal hasar hızlı bir şekilde selülit, abse veya fistül gelişimine zemin hazırlayabilmektedir. Olgumuz 7 yaşında erkek hasta olup yeni akut lenfoblastik lösemi tanısı konulmuştur. İndüksiyon tedavisi sırasında taburcu edilen hastaya iki gündür olan kabızlık nedeniyle evde rektal lavman uygulanması sonrasında tedavisinde geniş cerrahi debridman, kolostomi açılması ve otolog deri grafti uygulanması gerektirecek ağır nekrotizan perianal selülit gelişti. Olgu konunun önemini bir kez daha vurgulamak için sunulmuştur.

Anahtar Kelimeler

Çocuk, Lösemi, Nötropeni, Selülit

Kaynakça

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