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Management Strategies of Appendix with Mild Inflammation

Hafif inflamasyonlu apendisitte tedavi yaklaşımları

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Abstract (2. Language): 
Objective: In this study, we examined the cases with mild acute appendicitis and their treatments with different moda-lities and their follow up. Method: 45 patients were studied between August 2008 and January 2010, with further follow-up for 1 year. The patients were randomly allocated into three groups by systematic random sampling with an equal size of 15 to maintain balan-ce. First group was appendectomy group, second was antibi-otic group and third group was follow up (no treatment) group. Results: The median age of the patients was 25 (18-52) years. 34 (75.6%) were women and 11 (24.4%) were men. The mean white blood cell count was 7952±1698 /uL (4800-10700). The mean appendix wall thickness at ultrasonog-raphy was 5.46±0.35 (5,0-6,0) mm. There were no statistical difference detected between groups in age of patients, sex, white blood cell count and ultrasonography results (p=0.361, 0.894, 0.708 and 0.867). Of the patients who underwent surgery had proven appendicitis at histological examination. Two patients treated with antibiotics were readmitted with recurrent appendicitis, one patients after 2 weeks of treat-ment and one patient after 2 days of treatment and were subsequently operated in the second admission. However, no chronic findings were noted at histopathological examina-tion. Conclusion: Most of the early acute appendicitis, there is no need for appendectomy.
Abstract (Original Language): 
Amaç: Akut apandisit tedavisi halen klinik bir tartışmadır. Bu çalışmada, erken akut apandisit tanısı alan hastalarda değişik tedavi yaklaşımlarını ve bunların takiplerini tartış-mayı amaçladık. Yöntem: Ağustos 2008 ve Ocak 2010 tarihleri arasında erken dönem akut apandisit tanısı konulan 45 hasta çalış-maya dahil edildi ve bu hastaların 1 yıllık takip sonuçları incelendi. Bu hastalar 3 gruba randomize edildi. Birinci gruba apendektomi yapıldı, ikinci gruba antibiyotik tedavisi uygulandı ve üçüncü grup ise sadece izlendi. Bulgular: 45 hastanın ortanca yaşı 25 (18-52) idi. 34 hasta kadın (%75.6) ve 11 hasta (%24.4) erkek idi. Ortalama beyaz küre sayısı 7952±1698 /uL (4800-10700) olarak izlendi. Ultrasonografide ortalama apendiks duvar kalınlığı 5.46±0.35 (5,0-6,0) mm olarak tespit edildi. Gruplar arasın-da yaş, cinsiyet, beyaz küre sayısı ve ultrasonografi sonuçla-rı açısından farklılık yoktu (p=0.361, 0.894, 0.708 ve 0.867). Cerrahi yapılan grubun hepsinde patoloji sonuçları akut apandisit olarak geldi. Antibiyotik tedavi grubundan 2 hasta daha sonra tekrarlayan karın ağrısı şikayeti ile, biri 2 hafta sonra, diğeri ise 2 gün sonra tekrar hastaneye başvurdu ve bu hastalara apendektomi yapıldı, ancak patoloji raporla-rında kronik apandisit bulgusu saptanmadı. Sonuç: Apendektomi erken akut apandisit düşünülen hasta-ların çoğunda gerekli değildir.
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