Acute intestinal obstruction requiring surgery in pediatric malignancies: Summary of 7 cases

• We report various forms of acute intestinal obstruction in patients with malignancies.
• There were 5 hematologic, 2 solid malignancies.
• Treatment options include resection ± enterostomy or enterostomy alone.
• Operative intervention is effective in the treatment of such complications.
• Overall patient prognosis is dependent on the original disease.

Catheter-related or perianal problems are common surgical complications in patients with pediatric malignancies. Acute intestinal obstructions requiring surgical intervention are rare, however. We herein report our experience of 7 patients with separate primary diagnoses who developed acute intestinal obstruction that mandated surgery before or during chemotherapies. The original diseases were hematologic malignancies in 5 patients (3 leukemia, 1 lymphoma, 1 Langerhans cell histiocytosis (LCH)) and solid tumors in 2 patients (1 intra-abdominal desmoplastic small round cell tumor (DSRCT), 1 rhabdomyosarcoma of vagina). The intestinal obstructions were treated by resection of the involved segment with (N = 2) or without (N = 3) enterostomy. Two cases of intestinal obstruction were treated with an enterostomy alone. Three patients died due to the progression of the original disease, and 3 patients are currently alive. One patient was lost to follow-up. Although rare, acute intestinal obstructions can occur during the treatment course of pediatric malignancies or be an initial symptom of disease. Operative intervention is mandatory and effective in the treatment of such complications. Overall patient prognosis is dependent on the original disease.