Down sendromlu cinsel olarak aktif olmayan bir gençte tubo-ovaryan apse: Olgu sunumu ve literatürün kısa bir gözden geçirilmesi

Year 2018, Volume: 2 Issue: 3, 364 - 366, 01.09.2018

Ramazan Cahit Temizkan , Muhammet Mesut Nezir Engin , Harun Güneş Önder Kılıçaslan Merve Aslantaş , Murat Kaya Kenan Kocabay

https://doi.org/10.28982/josam.417557

Abstract

Tubo-ovarian apse, cinsel olarak aktif olan kadınlarda pelvik inflamatuar hastalık komplikasyonu olarak sık görülürken, cinsel olarak aktif olmayanlarda çok nadir görülür. Hastalık genellikle karın ağrısı ve ateş gibi spesifik olmayan semptomlarla ve / veya daha az sıklıkla vajinal akıntı ile kendini gösterir, bu nedenle acil hekimin erken tanı koyması zor olabilir. Hekimin tubo-ovarian apseyi hızlı bir şekilde teşhis etmesine veya dışlamasına ‘’point-of-care ultrasound’’ sistemi yani taşınabilir ultrason cihazı ile yatak başında hastanın ultrasonografisini yapması yardımcı olur. Tıbbi olarak (geniş spektrumlu antibiyotik tedavisi ile) veya cerrahi olarak (lezyonun drenaj veya çıkarılmasıyla) tedavi edilir. Karın ağrısı nedeniyle acil servise başvuran hastaların ayırıcı tanısında cinsel olarak aktif olmadıkları için pelvik inflamatuvar hastalık ve tubo-ovarian apse yer almıyorsa, gecikmeli tanıya bağlı ciddi komplikasyonlar görülebilir. Acil hekimleri cinsel olarak aktif olmayan hastada tubo-ovarian apse tanısını koyup tedavi ederken cinsel istismar yönünden uyanık olmalıdırlar. Down sendromu olan bir çocukta, zayıf kişisel hijyen ile ilişkili olduğu düşünülen ilk tubo-ovarian apse literatürün kısa bir gözden geçirmesiyle birlikte sunuldu.

Keywords

Down sendromu, Point-of-care ultrasound, Kötü kişisel hijyen, Tubo-ovaryan apse

Tuba-ovarian abscess in a sexually inactive teenager with Down syndrome: Case report and brief review of literature

Abstract

Tuba-ovarian abscess, a complication of pelvic inflammatory disease commonly seen in sexually active women, is very rarely encountered in sexually inactive ones. It commonly presents with non-specific symptoms like abdominal pain and fever and/or less commonly with vaginal discharge so it may be challenging for the emergency physician to make the diagnosis promptly. Point-of-care ultrasound may help physician to rapidly diagnose or exclude tubal ovarian abscess. It can be treated medically (with broad-spectrum antibiotic therapy) or surgically (by drainage or removal of the lesion). If pelvic inflammatory disease and tubal ovarian abscess are not included in the differential diagnosis of patients admitted to emergency department due to abdominal pain because the patient is not sexually active, the patient may suffer from some serious complications due to delayed diagnosis. Emergency physicians should be vigilant due to the possibility of sexual abuse while treating a sexually inactive patient with tubal ovarian abscess. The first case of tubal ovarian abscess, thought to be related to poor personal hygiene, in a child with Down syndrome was presented together with a short review of the literature.

Keywords

Down syndrome, Point-of-care ultrasound, Poor personal hygiene, Tubo-ovarian abscess

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