The surgical management of abdominal pain in the multiple myeloma patient

BackgroundThe purpose of this retrospective study was to characterize the presentation, treatment, and outcomes of patients with multiple myeloma requiring surgical evaluation for abdominal pain.MethodsMedical records of patients with myeloma and abdominal pain evaluated by surgery over a period of 18 months were examined.ResultsTwenty-one patients underwent surgical evaluation, with 23 diagnoses. Neutropenic enterocolitis (n = 5 [22%]) and ileus (n = 4 [17%]) were common diagnoses. Eleven patients (52%) were neutropenic. Peritonitis was noted in only 1 patient. Eastern Cooperative Oncology Group performance status was either 3 or 4 in most patients (67%). Surgery was performed in 5 patients. The 90-day mortality rate for all patients was 43%, with all deaths secondary to sepsis in patients managed without surgery.ConclusionsPatients with myeloma requiring surgical evaluation for abdominal pain have a unique differential diagnosis, with notable findings at presentation including the presence of cytopenia, lack of peritoneal signs, and low performance status.