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KARIN AĞRISI OLAN HASTALARIN CERRAHİ TANISINDA BAZI PARAMETRELERİN ETKİNLİĞİ

EFFECTIVENESS OF SOME PARAMETERS IN THE PATIENTS WITH ABDOMINAL PAIN IN SURGICAL DECISION MAKING

Journal Name:

  • Selçuk Tıp Dergisi

Publication Year:

  • 2008

Key Words:

Keywords (Original Language):

Author NameUniversity of Author
Abstract (2. Language): 
Aim: This study aimed to determine which of these parameters is effective in surgical decision making.Material and Method: The study population consisted of 87 patients, 56 (64%) male and 31 (36%) female [mean age, 8.18±1.25 years (±SD); range, 1 to 16 years], who were examined and investi¬gated in our department. Two groups were studied: Operated group (O group) who underwent surgery and included 76 children and nonoperated group (NO group) who did not undergone sur¬gery and included 11 children. In both groups age, gender, preoperative temperature, leukocyte count in blood and urine, the plain XRay film of the abdomen, abdominal ultrasonography (USG), nasogastric drenage (NGD), preoperative diagnosis and treatment were identified. Results: In pre-operative period temperature were significantly high in only perforated appendicitis compared with other causes of abdominal pain (P=0.028). Gase-liquid level in perforated appendicitis and gase image in acute appendicitis were significantly high compared with other causes of abdominal pain in plain graphy (P=0.001). USG was rather significant in the differential diagnosis of intussuception and mesenteric lymphadenopathy compared with other causes of abdominal pain in this period (P=0.000). In addition, USG was found as a valuable parameter in surgical decision making. Leukocyte count in blood (P=0.346), the leucocyte in urine (P=0.131), NGD (P=0.205) were not sig¬nificant in surgical making decision. Conclusion: It was shown that temperature were significantly high and gase-liquid level in the patients who are suspected to be perforated appendicitis of the patients who have abdominal pain in preoperative period. We may say that abdominal USG is effec¬tive especially in the differential diagnosis of intussuception and mesenter lymphadenitis to avoid unnecessary surgical procedures.
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Abstract (Original Language): 
Amaç: Karın ağrısı olan hastalarda preoperatif dönemde bazı parametrelerin cerrahi endikasyon açısından etkili olduğu bildirilmiştir. Çalışmamızın amacı, bu parametrelerden hangilerinin cerrahiye karar vermede etkin olduğunu belirlemektir. Gereç ve Yöntem: Karın ağrısı olan 56'sı (%64) erkek ve 31'i (%36) kız [ortalama yaş: 8.18±1.25 (1-16 arası)]; toplam 87 hasta üzerinde çalışıldı. 1. grubu opere edilen 76 hasta ve 2. grubu da opere edilmeyen 11 hasta oluşturdu. Her iki grupta da yaş, cinsiyet, preoperatif ateş (°C), kanda lökosit sayısı (LS) ve tam idrar tetkiki (TİT) nde lökosit, ayakta direkt karın grafisi (ADKG), karın ultrasonografisi (USG), nazogastrik drenaj (NGD), preoperatif tanı ve tedavi değerlendirildi. Bulgular: Preoperatif dönemde ateş, diğer karın ağrısı nedenleri ile karşılaştırıldığında sadece perfore apandisitte anlamlı olarak yüksekti (P=0.028). Yine ADKG'sinde per¬fore apandisitte gaz-sıvı seviyesi ve akut apandisitte de gaz görüntüsü diğer karın ağrısı nedenlerine göre anlamlı olarak yüksek bulundu (P=0.001). USG preoperatif dönemde diğer karın ağrısı neden¬leri ile karşılaştırıldığında, invajinasyon ve mezenter lenfadenitin ayırıcı tanısında anlamlı olup hasta¬ların cerrahiye gitmesinde karar verme açısından değerli bulundu (P=0.000). BK (P=0.346), TİT (P=0.131) ve NGD (P=0.205)'ın, hastaların cerrahiye gitmesine karar verme açısından anlamlı olmadığı tespit edildi. Sonuç: Karın ağrısı olan hastalardan perfore apandisitte preoperatif dönemde ateş yükselmekte ve ADKG'sinde gaz-sıvı seviyesi saptanmaktadır. Ayrıca karın ultrasonografisinin gereksiz cerrahi girişimlerden kaçınmak için preoperatif dönemde, özellikle invajinasyon ve mezenter lenfadenitin ayırıcı tanısında etkili olduğunu söyleyebiliriz.
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  • 3
153-158
  • Turkish

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