Kronik İmmun Trombositopenik Purpurada splenektomi Öncesi Tc-99m Sülfür Kolloid Sintigrafisi Gerekli mi?

Abstract

Eriºkinlerde elektif splenektominin en sýk nedenlerinden biri Kronik Ýmmun Trombositopenik Purpuradýr. Hastalýk trombositlerin dalak tarafýndan yýkýlmasý ile karakterizedir. Bu nedenle splenektomi tedavide altýn standarttýr. Ancak ameliyat sonrasý geride dalak dokusunun kalmasý trombositopeninin devam etmesine neden olur. Geride dalak dokusunun kalmasýnýn baºlýca nedeni aksesuar dalaktýr. Bu nedenle ameliyat öncesi ve sonrasý bu dokunun saptanmasý önemlidir. 30 yaºýnda erkek hasta. Dört yýl önce Kronik Ýmmun Trombositopenik Purpura nedeni ile laparoskopik splenektomi yapýlmýº. Hastanýn trombositopenisinin tekrarlamasý üzerine karýn utrasonografisi yapýlmýº ve normal olarak deðerlendirilmiº. Hastanýn yapýlan Tc-99m Sülfür Kolloid Dalak Sintigrafisinde sol hipokondriak bölgede dalak dokusu saptandý. Tc-99m Sülfür Kolloid Dalak Sintigrafisi ameliyat öncesi ve sonrasý aksesuar dalaðýn gösterilmesi için yapýlabilir bir görüntüleme yöntemidir. Özellikle ameliyat öncesi yapýlarak ameliyatta daha dikkatli olunmasý saðlanýr. Böylece saptanan aksesuar dalak çýkarýlarak hastalýðýn tekrar etmesi engellenmiº olur

Keywords

• Ýmmun Trombositopenik Purpura, Aksesuar Dalak, SPECT

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