Araştırma Makalesi
Yıl 2017,
Cilt: 9 Sayı: 1, 10 - 43, 30.01.2017
Öz
Öz
Amaç:Karın ağrısı nedeniyle acil polikliniklerine başvuran hastalara ilk yapılan tet-kiklerden biri tanısal değeri tartışmalı olsa da halen karın grafileridir. Yaptığımız çalışmada karın ağrısı nedeniyle acil polikliniğine başvuran hastalarda karın grafisi çekilmeoranını ve karın grafilerinin tanıya yaptıkları katkıyı incelemeyi amaçladık
Metod:Ordu Üniversitesi Tıp Fakültesi Eğitim Araştırma Hastanesi Acil Polikliniğine 1 ay boyunca karın ağrısı nedeniyle başvuran 317 hastanın kayıtlarını geriye dönük olarak inceledik. Karın ağrısı nedeniyle acile başvuran hastalarda karın grafisi çekilme oranını ve karın grafisinin tanıya olan katkısını araştırdık.
Bulgular:Karın ağrısı şikayetiyle acile başvuran 317 hastanın 148’ine (%46.7) karın grafisi çekildi. Karın grafisi bulgularına bakıldığında; hastaların %41.22 (n:61)’sinde normal bulgular, %49.32 (n:73)’sinde non spesifik bulgular ve %9.46 (n:14)’sında anormal bulgular tespit edildi. Karın grafisinde anormal bulgu tespit edilen 14 hastanın 8’inde tanı ve tedavi için başka bir görüntüleme tekniğine gerek duyulmadı.
Sonuç:Karın ağrısı nedeniyle acil polikliniğine başvuran hastalarda doğru tanı koyabilmek için, ilk ve yaygın olarak yapılan görüntüleme tetkiklerinden biri halen karın grafileridir. Karın ağrısı olan hastalarda iyi bir anamnez ve fizik muayene sonrası hangi hastaya karın grafisi çekilip çekilmeyeceği belirlenmeli ve gereksiz yere çekilmemelidir.
Anahtar Kelimeler
Kaynakça
- Kaynaklar 1.van Randen A, Laméris W, Luitse JS, et al The role of plainradiographs in patients with acute abdominal pain at the ED.Am J Emerg Med 2011; 29:582–589. 2. Lameris W, van Randen A, van Es HW, et al. Imaging stra-tegies for detection of urgent conditions in patients with acu-te abdominal pain: diagnostic accuracy study. Br Med J.2009;338:b2431. 3. Lee PWR. The plain x-ray in the acute abdomen: a surgeonsevaluation. Br J Surg.1976; ;63:763—6. 4. Brazaitis MP, Dachman AH. The radiological evaluation ofacute abdominal pain of intestinal origin. A clinical appro-ach. Med Clin North Am 1993;77:939–61. 5. Graff LG, Robinson D. Abdominal pain and emergency depart-ment evaluation. Emerg Med Clin North Am 2001;19:123-36. 6.Karkhanis S, Medcalf J. Plain abdomen radiographs: the rightview? Eur J Emerg Med. 2009;16(5):267–270. 7.Hastings RS, Powers RD. Abdominal pain in the ED: a 35year retrospective. Am J Emerg Med. 2011;29(7):711–716. 8.Zeina AR, Shapira-Rootman M, Mahamid A, Ashkar J, Abu-Mouch S, Nachtigal A. Role of Plain Abdominal Radiographsin the Evaluation of Patients with Non-Traumatic AbdominalPain.Isr Med Assoc J. 2015 Nov;17(11):678-81 9.Ahn SH, Mayo-Smith WW, Murphy BL, Reinert SE, CronanJJ. Acute nontraumatic abdominal pain in adult patients: ab-dominal radiography compared with CT evaluation. Radiology 2002; 225:159–164 10. Prasannan S, Zhueng TJ, Gul YA. Diagnostic Value of Pla-in Abdominal Radiographs in Patients with Acute AbdominalPain. Asian J Surg. 2005 Oct;28(4):246-51 11.Smith JE, Hall EJ. The use of plain abdominal X rays in theemergency department. Emerg Med J 2009; 26:160–163.doi:10.1136/emj.2008.059113 12.Böhner H, Yang Q, Franke C, et al. Simple data from historyand physical examination help to exclude bowel obstructionand to avoid radiographic studies in patients with acute ab-dominal pain. Eur J Surg 1998; 164:777–784.doi:10.1080/110241598750005435 13.Royal College of Radiologists. Referral guidelines for imaging.http://ec.europa.eu/energy/nuclear/radioprotection/publica-tion/doc/118_en.pdf 2000: 1–127. 14. American College of Radiologists. Practice guideline for theperformance of abdominal radiography. Radiography.2006:1–5. 15.Lappas JC, Reyes BL, Maglinte DD. Abdominal radiographyfindings in small-bowel obstruction: relevance to triage foradditional diagnostic imaging. AJR Am J Roentgenol2001;176:167-74. 16.Thompson WM, Kilani RK, Smith BB, et al. Accuracy of ab-dominal radiography in acute small-bowel obstruction: doesreviewer experience matter? AJR Am J Roentgenol2007;188:W233-8. 17.Miller RE, Nelson SW. The roentgenologic demonstration oftiny amounts of free intraperitoneal gas: experimental and cli-nical studies. Am J Roentgenol Radium Ther Nucl Med.1971;112(3):574–585. 18. Roh JJ, Thompson JS, Harned RK, Hodgson PE. Value of pneu-mo¬peritoneum in the diagnosis of visceral perforation. AmJ Surg. 1983; 146(6):830–833. 19. Gans SL, Stoker J, Boermeester MA. Plain abdominal radi-ography in acute abdominal pain; past, present, and future.Int J Gen Med. 2012;5:525-33 20. Gupta K, Bhandari RK, Chander R. Comparative study of pla-in abdomen and ultrasound in non-traumatic acute abdomen.Ind J Radiol Imag 2005;15:109-15. 21.Hainaux B, Agneessens E, Bertinotti R, et al. Accuracy ofMDCT in predicting site of gastrointestinal tract perforation.AJR Am J Roentgenol 2006;187:1179-83. 22.Bansal J, Jenaw RK, Rao J, et al. Effectiveness of plain ra-diography in diagnosing hollow viscus perforation: study of1,723 patients of perforation peritonitis. Emerg Radiol 2011. 23.Boleslawski E, Panis Y, Benoist S, et al. Plain abdominal ra-diography as a routine procedure for acute abdominal painof the right lower quadrant: prospective evaluation. World JSurg 1999;23:262–4. 24.Rodrigues G, Kanniayan L, Gopashetty M, Rao S, Shenoy R(2004). Plain X-ray in Actue Appendicits. The internet J. ra-diol. Vol 3. No:2 25.Campbell JP, Gunn AA. Plain abdominal radiographs and acu-te abdominal pain. Br J Surg 1988;75:554–6. 26.Mutgi A, Williams JW, Nettleman M. Renal colic: utility of theplain abdominal roentgenogram. Arch Intern Med.1991;151(8): 1589–1592. 27. Roth CS, Bowyer BA, Berquist TH. Utility of the plain abdo-mi¬nal radiograph for diagnosing ureteral calculi. AnnEmerg Med. 1985;14(4):311–315. 28. Yilmaz S, Sindel T, Arslan G, et al. Renal colic: comparisonof spiral CT, US and IVU in the detection of ureteral calcu-li. Eur Radiol. 1998;8(2): 212–217. 985;14(4):311–315. 29.Krishnan A, Brown R. Plain abdominal radiography in the di-agnosis of the ‘body packer.’. J Accid Emerg Med 1999;16:381. 30.Makanjuola D, Al-Qasabi Q, Malabarey T (1993). A compa-rative ultrasound and plain abdominal x-ray: Evaluation ofnon-classical clinical cases of appendicitis. Ann Saudi Med.13(1): 41-46 31.Wall BF, Hart D. Revised radiation doses for typical X-ray exa-minations. Report on a recent review of doses to patients frommedical X-ray examinations in the UK by NRPB. National Ra-diological Protection Board. Br J Radiol 1997; 70: 437-9.
Yıl 2017,
Cilt: 9 Sayı: 1, 10 - 43, 30.01.2017
Öz
Kaynakça
- Kaynaklar 1.van Randen A, Laméris W, Luitse JS, et al The role of plainradiographs in patients with acute abdominal pain at the ED.Am J Emerg Med 2011; 29:582–589. 2. Lameris W, van Randen A, van Es HW, et al. Imaging stra-tegies for detection of urgent conditions in patients with acu-te abdominal pain: diagnostic accuracy study. Br Med J.2009;338:b2431. 3. Lee PWR. The plain x-ray in the acute abdomen: a surgeonsevaluation. Br J Surg.1976; ;63:763—6. 4. Brazaitis MP, Dachman AH. The radiological evaluation ofacute abdominal pain of intestinal origin. A clinical appro-ach. Med Clin North Am 1993;77:939–61. 5. Graff LG, Robinson D. Abdominal pain and emergency depart-ment evaluation. Emerg Med Clin North Am 2001;19:123-36. 6.Karkhanis S, Medcalf J. Plain abdomen radiographs: the rightview? Eur J Emerg Med. 2009;16(5):267–270. 7.Hastings RS, Powers RD. Abdominal pain in the ED: a 35year retrospective. Am J Emerg Med. 2011;29(7):711–716. 8.Zeina AR, Shapira-Rootman M, Mahamid A, Ashkar J, Abu-Mouch S, Nachtigal A. Role of Plain Abdominal Radiographsin the Evaluation of Patients with Non-Traumatic AbdominalPain.Isr Med Assoc J. 2015 Nov;17(11):678-81 9.Ahn SH, Mayo-Smith WW, Murphy BL, Reinert SE, CronanJJ. Acute nontraumatic abdominal pain in adult patients: ab-dominal radiography compared with CT evaluation. Radiology 2002; 225:159–164 10. Prasannan S, Zhueng TJ, Gul YA. Diagnostic Value of Pla-in Abdominal Radiographs in Patients with Acute AbdominalPain. Asian J Surg. 2005 Oct;28(4):246-51 11.Smith JE, Hall EJ. The use of plain abdominal X rays in theemergency department. Emerg Med J 2009; 26:160–163.doi:10.1136/emj.2008.059113 12.Böhner H, Yang Q, Franke C, et al. Simple data from historyand physical examination help to exclude bowel obstructionand to avoid radiographic studies in patients with acute ab-dominal pain. Eur J Surg 1998; 164:777–784.doi:10.1080/110241598750005435 13.Royal College of Radiologists. Referral guidelines for imaging.http://ec.europa.eu/energy/nuclear/radioprotection/publica-tion/doc/118_en.pdf 2000: 1–127. 14. American College of Radiologists. Practice guideline for theperformance of abdominal radiography. Radiography.2006:1–5. 15.Lappas JC, Reyes BL, Maglinte DD. Abdominal radiographyfindings in small-bowel obstruction: relevance to triage foradditional diagnostic imaging. AJR Am J Roentgenol2001;176:167-74. 16.Thompson WM, Kilani RK, Smith BB, et al. Accuracy of ab-dominal radiography in acute small-bowel obstruction: doesreviewer experience matter? AJR Am J Roentgenol2007;188:W233-8. 17.Miller RE, Nelson SW. The roentgenologic demonstration oftiny amounts of free intraperitoneal gas: experimental and cli-nical studies. Am J Roentgenol Radium Ther Nucl Med.1971;112(3):574–585. 18. Roh JJ, Thompson JS, Harned RK, Hodgson PE. Value of pneu-mo¬peritoneum in the diagnosis of visceral perforation. AmJ Surg. 1983; 146(6):830–833. 19. Gans SL, Stoker J, Boermeester MA. Plain abdominal radi-ography in acute abdominal pain; past, present, and future.Int J Gen Med. 2012;5:525-33 20. Gupta K, Bhandari RK, Chander R. Comparative study of pla-in abdomen and ultrasound in non-traumatic acute abdomen.Ind J Radiol Imag 2005;15:109-15. 21.Hainaux B, Agneessens E, Bertinotti R, et al. Accuracy ofMDCT in predicting site of gastrointestinal tract perforation.AJR Am J Roentgenol 2006;187:1179-83. 22.Bansal J, Jenaw RK, Rao J, et al. Effectiveness of plain ra-diography in diagnosing hollow viscus perforation: study of1,723 patients of perforation peritonitis. Emerg Radiol 2011. 23.Boleslawski E, Panis Y, Benoist S, et al. Plain abdominal ra-diography as a routine procedure for acute abdominal painof the right lower quadrant: prospective evaluation. World JSurg 1999;23:262–4. 24.Rodrigues G, Kanniayan L, Gopashetty M, Rao S, Shenoy R(2004). Plain X-ray in Actue Appendicits. The internet J. ra-diol. Vol 3. No:2 25.Campbell JP, Gunn AA. Plain abdominal radiographs and acu-te abdominal pain. Br J Surg 1988;75:554–6. 26.Mutgi A, Williams JW, Nettleman M. Renal colic: utility of theplain abdominal roentgenogram. Arch Intern Med.1991;151(8): 1589–1592. 27. Roth CS, Bowyer BA, Berquist TH. Utility of the plain abdo-mi¬nal radiograph for diagnosing ureteral calculi. AnnEmerg Med. 1985;14(4):311–315. 28. Yilmaz S, Sindel T, Arslan G, et al. Renal colic: comparisonof spiral CT, US and IVU in the detection of ureteral calcu-li. Eur Radiol. 1998;8(2): 212–217. 985;14(4):311–315. 29.Krishnan A, Brown R. Plain abdominal radiography in the di-agnosis of the ‘body packer.’. J Accid Emerg Med 1999;16:381. 30.Makanjuola D, Al-Qasabi Q, Malabarey T (1993). A compa-rative ultrasound and plain abdominal x-ray: Evaluation ofnon-classical clinical cases of appendicitis. Ann Saudi Med.13(1): 41-46 31.Wall BF, Hart D. Revised radiation doses for typical X-ray exa-minations. Report on a recent review of doses to patients frommedical X-ray examinations in the UK by NRPB. National Ra-diological Protection Board. Br J Radiol 1997; 70: 437-9.
Toplam 1 adet kaynakça vardır.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Ocak 2017 |
| Yayımlandığı Sayı | Yıl 2017 Cilt: 9 Sayı: 1 |
