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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

REFERENCES

References: 

1. Doraiswamy NV: Leucocyte counts in the diagno¬sis of acute appendicitis in children. Br J Surg 1979;66:782-785
2. Eisenberg RL, Heineken P, Hedgcock MW, et al: Evaluation of plain abdominal radiographs in the diagnosis of abdominal pain. Ann Surg 1983;197:464-467
3. Lawson TL: Acute pancreatitis and its complicati¬ons: Computed tomography and sonography. Ra¬diol Clin North Am 1983;21:495-506
4. Ramachandran P, Sivit CJ, Newman KD, et al: Ult¬rasonography as an adjunct in the diagnosis of acute appendicitis: A 4-year experience. J Pediatr Surg 1996;31(1): 164-169
5. Rubin SZ, Martin DJ: Ultrasonography in the ma-nagement of possible appendicitis in childhood; Journal of Pediatric Surgery 1990;25(7): 737-740
6. Nural MS, Ceyhan M, Baydin A, et al:: The role of ultrasonography in the diagnosis and manage-ment of non-traumatic acute abdominal pain. In-tern Emerg Med Apr 2008;29:[Epub ahead of print]
7. Gallinas-Victoriano F, Garde-Lecumberri C, Pérez-Martínez A, et al: Ultrasonography for surgical pat¬hology discrimination in acute abdominal pain.
[Prospective study]. Cir Pediatr 2004;17(3):141-144
8. Franke C, Böhner H, Yang Q, et al: Ultrasonog-raphy for diagnosis of acute appendicitis: results of a prospective multicenter trial. Acute Abdominal Pain Study Group. World J Surg 1999;23(2):141-146
9. Nosaka S, Hayakawa M, Miyazaki O, et al: Ultraso¬nography of pediatric right lower abdominal pain: correlation with clinical and pathological results. Nippon Igaku Hoshasen Gakkai Zasshi 1995;55(12):855-860
10. Everarts P, Clapuyt P, Claus D, et al: The role of ult-rasonography in abdominal pain in children in the emergency room. J Belge radiol 1994;77(5):201-
203
11. Siegel MJ, Carel C, Surratt S: Ultrasonography of acute abdominal pain in children. JAMA 1991;9;226(14):1987-1989
12. Hernandez JA, Swischuk LE, Angel CA, et al: Imaging of acute appendicitis: US as the primary imaging modality. Pediatr Radiol 2005;35(4):392-
395
13. Schulte B, Beyer D, Kaiser C, et al: Ultrasonog-raphy in suspected acute appendicitis in child¬hood-report of 1285 cases. Eur J Ultrasound
1998;8(3):177-182
14. Spehl-Robberecht M, Toppet-Hoegars-Muller V: Contribution of digestive system ultrasonography in the assessment of abdominal pain in children. Rev Med Brux 1994;15(6):376-381
15. Moore J, Bartholomeusz D, Wycherley A, et al: 99m Technetium labelled leucocyte scanning in acute lower abdominal pain: can it reduce the negative appendectomy rate? Aust N Z J Surg 1995;65(6):403-405
16. Parker JS, Vukov LF, Wollan PC: Abdominal pain in the elderly: use of temperature and laboratory testing to screen for surgical disease. Fam Med 1996;28(3):193-197
17. Hoffman J, Kurgan A, Abramowitz HB: Rectal tem¬perature in the diagnosisof acute lower ab-dominal pain. Isr J Med Sci Jun 1993;19(6): 505-507

18. Pearl RH: Pediatric appendectomy. J Pediatr Surg
1995;30:173
19. Dunn JCY: Appendicitis, in Grosfeld JL, O'Neill JA, Fonkalsrud EW, Coran AG (eds): Pediatric Surgery. Philadelphia, Mosby Elsevier 2006, p: 1501-1513
20. Stevenson RJ: Appendicitis, in Ziegler MM, Azizk-han RG, Weber TR (eds): Operative Pediatric Sur¬gery. New York, McGraw-Hill 2003, p: 671-689
21. Zielke A, Sitter H, Rampp T, et al: Clinical decision-making, ultra-sonography and scores for evalua¬tion of suspected acute appendicitis. World J Surg
2001;25:578-584

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