AKUT ABDOMİNAL ŞİKAYETİ OLAN ÇOCUKLARDA BİLGİSAYARLI TOMOGRAFİ KULLANIMININ DEĞERLENDİRİLMESİ

Öz

ÖZET Amaç: Bilgisayarlı tomografi, radyasyona rağmen çocuklarda sıklıkla kullanılmaktadır. Çalışmanın amacı, acil kliniğe başvuran çocuklarda bilgisayarlı tomografi isteme nedenlerini belirlemektir. Yöntemler: 2021 Ocak - 2022 Ocak tarihleri arasında travmatik olmayan nedenlerle başvuran ve bilgisayarlı tomografi çekilen 319 çocuk retrospektif çalışmaya dahil edildi. Hastaların alt ve üst abdominal bilgisayarlı tomografi rapor sonuçları, demografik özellikleri, semptomları, fizik muayene ve laboratuvar bulguları taranarak elektronik veri sisteminden kaydedildi. Bulgular: Hastaların 166'sı (%52) erkek, 153'ü (%48) kadındı. Ortalama yaş 11,80 ± 4,13 yıldı. 110 (%34) hastada bulgu saptanmazken, 85 (%27) hastada akut cerrahi batın bulguları saptandı. 85 hastanın 79'unda akut apandisit düşündüren bulgular saptandı. Erkek cinsiyet, kabızlık şikayeti, sağ alt kadranda hassasiyet ve fizik muayenede defans, akut cerrahi abdominal bulguları olan çocuklarda bulgusu olmayan çocuklara göre anlamlı olarak daha yüksekti (sırasıyla p<0,001, p=0,026, p<0,001 ve p<0,020). Akut cerrahi patolojisi şüphesi olan hastalarda mutlak nötrofil sayısı (p<0,001) ve nötrofil lenfosit oranı kesme değeri (p<0,001) yaşa göre anlamlı olarak daha yüksek bulundu. Sonuç: Çalışma, bilgisayarlı tomografinin özellikle akut apandisit tanısını dışlamak için çocuk acil servislerinde sıklıkla kullanıldığını ortaya koymuştur. Bilgisayarlı tomografinin kullanımı, şüpheli ön tanıya göre ayrıntılı öykü, fizik muayene, laboratuvar testleri ve radyasyonsuz görüntüleme çalışmaları kullanılarak azaltılabilir. Anahtar kelimeler: Çocuk Acil, Bilgisayarlı Tomografi, Çocuklar. ABSTRACT Objective: Computed tomography is frequently used in children despite radiation. The aim of the study is to determine the reasons for requesting computed tomography in children presenting to the emergency clinic. Methods: Between 2021 January and 2022 January, 319 children who applied for non traumatic reasons and underwent computed tomography were included in the retrospective study. The patients' lower and upper abdominal computed tomography report results, demographic characteristics, symptoms, physical examination and laboratory findings were scanned and recorded from the electronic data system. Results: Of the patients, 166 (52%) were male and 153 (48%) were female. The mean age was 11.80 ± 4.13 years. While no findings were detected in 110 (34%) patients, findings of acute surgical abdomen were detected in 85 (27%). Findings suggestive of acute appendicitis were detected in 79 of the 85 patients. Male gender, constipation complaint, tenderness in the right lower quadrant and defence on physical examination were significantly higher in children with acute surgical abdominal findings compared to children without findings (p<0.001, p=0.026, p<0.001 and p<0.020 respectively) .In patients with suspected acute surgical pathology, ANC (p<0.001) and NLR cut-off value (p<0.001) were found to be significantly higher according to age. Conclusion: The study revealed that computed tomography is frequently used in pediatric emergency services, especially to exclude the diagnosis of acute appendicitis. The use of computed tomography can be reduced by using detailed history, physical examination, laboratory tests and radiation-free imaging studies according to the suspected preliminary diagnosis. Keywords: Pediatric Emergency, Computed Tomography, Children.

Anahtar Kelimeler

• Çocuk Acil
• Bilgisayarlı Tomografi
• Çocuklar.

Evaluation of the Use of Computerized Tomography to Diagnose Children with Acute Abdominal Complaint

Öz

ABSTRACT Objective: Computed tomography is frequently used in children despite radiation. The aim of the study is to determine the reasons for requesting computed tomography in children presenting to the emergency clinic. Methods: Between 2021 January and 2022 January, 319 children who applied for non traumatic reasons and underwent computed tomography were included in the retrospective study. The patients' lower and upper abdominal computed tomography report results, demographic characteristics, symptoms, physical examination and laboratory findings were scanned and recorded from the electronic data system. Results: Of the patients, 166 (52%) were male and 153 (48%) were female. The mean age was 11.80 ± 4.13 years. While no findings were detected in 110 (34%) patients, findings of acute surgical abdomen were detected in 85 (27%). Findings suggestive of acute appendicitis were detected in 79 of the 85 patients. Male gender, constipation complaint, tenderness in the right lower quadrant and defence on physical examination were significantly higher in children with acute surgical abdominal findings compared to children without findings (p<0.001, p=0.026, p<0.001 and p<0.020 respectively). In patients with suspected acute surgical pathology, ANC (p<0.001) and NLR cut-off value (p<0.001) were found to be significantly higher according to age. Conclusion: The study revealed that computed tomography is frequently used in pediatric emergency services, especially to exclude the diagnosis of acute appendicitis. The use of computed tomography can be reduced by using detailed history, physical examination, laboratory tests and radiation-free imaging studies according to the suspected preliminary diagnosis.

Anahtar Kelimeler

• Pediatric Emergency
• Computed Tomography
• Children.

Kaynakça

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