It's not always appendicitis: relatively uncommon conditions of acute abdomen in children

Year 2021, , 215 - 219, 25.03.2021

Berat Dilek Demirel , Beytullah Yağız

https://doi.org/10.16899/jcm.863986

Abstract

Aim: To evaluate the acute surgical conditions beyond acute appendicitis in children.
Material and method: The children who underwent urgent abdominal surgery between January 2017-December 2020 are retrospectively evaluated. The newborns and patients with acute appendicitis are excluded.
Results: A total of 595 patients underwent urgent abdominal surgery. Acute appendicitis was the final diagnosis in 468 of them (78.7%). The median age of the rest of the 127 patients (21.3%) was 8 years (0.96-17.75 years). Fourteen patients admitted with trauma (11%) (12 boys and 2 girls, median age; 12.66 years), and the most common cause was firearm injuries with the most common injured system was the gastrointestinal system. Among the patients without trauma, 62 were boys (54.6%) and 51 were girls (45.1%) (median age; 6.41 years). Intussusception was most common in the Infant and Young Child Group. Adhesive small bowel obstruction was most common in adolescent boys and the Child Group while adnexal torsion was most common in adolescent girls. Intussusception, adhesive small bowel obstruction and gastrointestinal perforation were encountered in all age groups
Conclusion: Although acute appendicitis is the most common cause of acute abdomen in children, other causes are not uncommon and some need special attention as differential diagnosis and intervention are "more urgent" than others. Awareness of these "more urgent" conditions with respect to age groups may prevent complications, morbidity, and even mortality.

Keywords

abdomen, acute, intussusception, adnexal torsion, intestinal obstruction

Her zaman apandisit değildir: çocuklarda nadir görülen akut karın nedenleri

Abstract

Amaç: Çocuklarda akut apandisit dışı akut cerrahi nedenlerin değerlendirilmesi.
Gereç ve yöntem: Ocak 2017- Aralık 2020 tarihleri arasında acil karın cerrahisi yapılan çocuk hastalar retrospektif olarak değerlendirildi. Yenidoğan dönemindeki hastalar ve apandisit nedeniyle ameliyat edilen hastalar çaışma dışı bırakıldı.
Bulgular: 595 hastaya acil abdominal cerrahi yapıldı. 468'inde (%78,7) kesin tanı apandisitti. Apandisit dışı nedenle ameliyat edilen 127 hastanın (%21,3) ortanca yaşı 8 (0,96- 17,75) yıldı. Travma ile başvuran 14 (%11) hasta vardı (12 erkek, 2 kız, ortanca yaş; 12,66 yıl). En sık travma nedeni ateşli silah yaralanması ve en sık yaralanma gastrointestinal sistemde yaralanmasıydı. Nontravmatik Grupta 62 (%54,6) hasta erkek ve 51 (%45,1) hasta kızdı ( ortanca yaş; 6,41 yıl). İnfantlarda ve küçük çocuklarda en sık invajinasyon görüldü. Ergen erkeklerde ve Çocuk Grubunda en sık adhesiv barsak tıkanıklığı görülürken, ergen kızlarda en sık adneksiyal torsiyon görüldü. İnvajinasyon, adhesiv barsak tıkanıklığı ve gastrointestinal perforasyon tüm yaş gruplarında görüldü.
Sonuç: Çocuklarda en sık akut karın nedeni akut apandisit olsa da, diğer nedenler de nadir değildir ve ayırıcı tanı ve müdahalenin "daha acil" olması nedeniyle dikkat edilmelidir. Yaş gruplarına göre bu "daha acil" durumların farkında olunması komplikasyonları, morbiditeyi ve hatta mortaliteyi önleyebilir.

Keywords

karın, akut, intususepsiyon, adneksiyal torsiyon, barsak tıkanıklığı

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