THE ACUTE ABDOMEN.

Pediatric oncology patients develop similar abdominal emergencies as immunocompetent children in addition to acute abdomen from malignancy or secondary to treatment. Cytotoxic chemotherapy, radiotherapy and extensive surgical resection all contribute to the risk of gastrointestinal symptoms. Immunocompromised children may lack the inflammatory signs of acute abdomen making prompt diagnosis of pediatric oncologic abdominal emergencies challenging. Here we review the most common abdominal emergencies secondary to malignancy including gastrointestinal hemorrhage, infection, mechanical obstruction, and perforation as well as management strategies for these conditions. A high index of suspicion and a prompt multidisciplinary approach are essential for optimal patient care. Early initiation of aggressive medical management reduces the need for invasive surgical treatment and concomitantly improves mortality rates. As there is a lack of evidence-based guidelines, the reviewed recommendations for supportive care and treatment of pediatric oncologic abdominal emergencies predominantly stem from expert opinion.