Introduction
Perianal complaints are relatively common in patients on
chemotherapy and in patients with neutropenia.1e3 Surgeons
are often called to assess and manage such patients.
The main concern is the presence of perianal infection, especially
in patients with febrile neutropenia, as it can be
the cause of sepsis and possible mortality. Perianal sepsis
in such patients has been reported to be associated with
a mortality rate up to 78%.2e6 While non septic perianal
conditions, like piles and fissures, are mostly treated conservatively,
septic conditions usually need more attentive
treatment and might require urgent surgery.
Perianal infections in patients with immune suppression
resulting from chemotherapy are approached differently
from their non suppressed, non cancer counterparts. Those
patients are usually sick with multiple problems and organ
compromise. In addition, some have low platelets counts
which increase the liability for bleeding. Therefore the decision
for surgical intervention is more complex and takes
many factors into consideration. There are only few studies
dealing with the management of perianal conditions in cancer
patients and even fewer in neutropenic patients.7,8
The purpose of this study was to examine the frequency
and type of perianal conditions in febrile neutropenic patients
resulting from chemotherapy in a contemporary series
of cancer patients at our Cancer Center. We also
wanted to shed light on the risk factors, management options
and outcome of septic conditions, like perianal abscess
and fistula.