Adem CANAN, Mustafa ÇAKAN, Sinem DAŞTAN, Kıvıcım CERİT KARADENİZ, Ahmet KOÇ, Barış YILMAZ

Akut Lenfoblasti̇k Lösemi̇li̇ Çocukta Nötropeni̇ k Dönemde Rektal Lavman Uygulaması Sonucu Geli̇şen Ağır Nekroti̇ zan Peri̇anal Selüli̇

Hematolojik malignite nedeniyle kemoterapi alan hastalarda, özellikle nötropenik olduğu dönemlerde rektal uygulamalarciddi komplikasyonlara yol açabileceği için önerilmemektedir. Uygulama sırasında anüs veya rektum mukozasındaoluşabilecek minimal hasar hızlı bir şekilde selülit, abse veya ﬁ stül gelişimine zemin hazırlayabilmektedir. Olgumuz 7 yaşındaerkek hasta olup yeni akut lenfoblastik lösemi tanısı konulmuştur. İndüksiyon tedavisi sırasında taburcu edilen hastaya ikigündür olan kabızlık nedeniyle evde rektal lavman uygulanması sonrasında tedavisinde geniş cerrahi debridman, kolostomiaçılması ve otolog deri grafti uygulanması gerektirecek ağır nekrotizan perianal selülit gelişti. Olgu konunun önemini bir kezdaha vurgulamak için sunulmuştur.

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

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

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