Çocuklarda Kistik Ekinokokkoz: On Yıllık Tecrübe ve Rüptüre Olguları Değerlendirmede Hangi Laboratuar Sonucu?

Abstract

Amaç Kist hidatik hastalığı (Echinococcosis) Türkiye gibi hayvancılıkla uğraşan ülkelerde yaygın olan bir zoonozdur. Bölgemizde son 10 yılda görülen çocuk kist hidatik olgularını değerlendirip, rüptüre kist hidatik olgularını ayırt etmede başlangıç klinik ve laboratuvar bulgularının önemini belirlemektir. Gereç ve yöntem Ocak 2011-Aralık 2020 tarihleri arasında hastanemizde tedavi edilen ve düzenli olarak takiplere gelen kist hidatikli çocukların demografik özellikleri, başvuru şikayeti, fizik muayene, laboratuvar, radyolojik bulguları ve tedavileri geriye dönük incelendi. Bulgular Çalışmaya dahil edilen kırk iki olgunun 19’u kız (%45,2), ortanca yaşları 125,5 (34-209) aydı. En yaygın belirti %50 ile karın ağrısı, en yaygın fizik muayene bulgusu ise %23,8 ile solunum seslerinde azalmaydı. Hastaların 35’inde de (%83,3) tek organ, 7’sinde (16,7) çoklu organ tutulumu vardı. Karaciğer kist hidatiklerinin 24’ünde (%75) kist karaciğerin sağ lobunda, akciğer kist hidatiklerinin ise 7’si (%58,3) sol lobunda tespit edildi. Kistlerin ortanca boyu 57,5 mm (12-140 mm) idi. Rüptüre kisti olan hastalarda başlangıç İHA titresi, eozinofil sayısı, eozinofil yüzdesi ve sedimantasyon değeri rüptür olmayan hastalara göre istatistiksel olarak anlamlı yüksekti (sırasıyla p=0,002, p=0,003, p=0,003, p=0,02). Sonuç İlk başvuruda patolojik muayene bulgusu ve yüksek İHA titresi, eozinofil sayısı, eozinofil yüzdesi ve sedimantasyon değeri rüptür olgularını ayırt etmek için kullanılabilir.

Keywords

• Akciğer
• karaciğer
• kist
• pediatri

Cystic Echinococcosis in Children: Ten Years of Experience and Which Laboratory Result in Evaluating Ruptured Cases?

Abstract

Aim Hydatid disease (Echinococcosis) is a common zoonosis in countries that are involved in livestock such as our country. Our study aims to evaluate pediatric cases with hydatid disease over the last decade in our region and to determine the significance of initial clinical and laboratory findings in distinguishing ruptured hydatid cyst cases. Materials and Methods A retrospective analysis was made on demographic characteristics, presenting symptoms, physical examination, laboratory and radiological findings, and treatments of children with hydatid disease who were treated in our hospital and followed up regularly between January 2011 and December 2020. Results The study sample of 42 cases included 19 (45.2%) girls, with a median age of 125.5 (34-209) months. The most common symptom was abdominal pain (50%), and the most common physical examination finding was decreased breath sounds (23.8%). Thirty-five (83.3%) patients had single organ involvement and 7 (16.7) patients had multiple organ involvement. Cysts were detected in the right lobe of the liver in 24 (75%) of hepatic hydatid cysts and the left lobe in 7 (58.3%) of pulmonary hydatid cysts. The median size of the cysts was 57.5 (12-140) mm. The initial IHA titer, eosinophil count, eosinophil percentage, and sedimentation value were statistically significantly higher in patients with ruptured cysts than in those without rupture (p= 0.002, p= 0.003, p= 0.003, p= 0.02, respectively). Conclusions Initial pathological examination findings and at initial laboratory findings such as high IHA titer, eosinophil count, eosinophil percentage, sedimentation value can be used to distinguish rupture cases.

Keywords

• Cyst
• liver
• lung
• pediatrics

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