Çocuklarda Ender Bir Antite: Mide Duvar Absesi

Yıl 2017, Cilt: 11 Sayı: 2, 141 - 143, 01.06.2017

Ergun Ergün Adalet Elçin Yıldız Gülnur Göllü Yasemin Dere Günal Gönül Küçük Mehmet Bektaş Suat Fitox Meltem Bingöl Koloğlu

Öz

Mide duvarı abseleri, ender enfeksiyöz patolojilerdir. Karın ağrısı ve kusma ile kabul edilen ve mide duvarı absesi tanısı alan 11 yaşındaki erkek çocuğun sunulması amaçlandı. İki gün önce başlayan karın ağrısı ve kusma ile kabul edildi. Öyküsünde Myasthenia Gravis tanısı mevcuttu. Bilgisayarlı tomografisinde, perigastrik inflamasyon ve submukozal multipl abselerden kaynaklanan pilor ve antrumda fokal duvar kalınlaşması görüldü. Hastanın oral alımı kesildi ve parenteral antibiyotik tedavisi başlandı. On günlük antibiyotik tedavisi sonrasında hasta taburcu edildi. Üçüncü haftadaki kontrol ultrasonografisinde antrum ve pilorda minimal duvar kalınlaşması izlendi. Mide duvar abseleri, maligniteden ayırt edilmesi gereken ender antitelerdir. Bu olgu, çocuk hasta grubunda herhangi bir girişime gerek kalmadan parenteral antibiyoterapi ile tedavi edilen ilk mide duvarı absesi olgusudur.

Anahtar Kelimeler

Karın ağrısı, Abse, Antibiyotik, Çocuk, Mide

A Rare Entity in Children: Gastric Abscess

Öz

Gastric wall abscesses are rare infectious pathologies. We present a 11-year-old boy who had complaints of abdominal pain and vomiting and was diagnosed as gastric wall abscess. He presented with complaints of abdominal pain and vomiting that had started two days ago. He also had a history of Myasthenia Gravis. Computerized tomography scans revealed increased focal thickness between the pylorus and antrum, marked perigastric inflammation and submucosal multiple abscesses in the gastric wall. Oral intake was stopped and parenteral antibiotic treatment was started. After ten days of antibiotic treatment, the patient was discharged. Three weeks later, abdominal ultrasonography revealed minimal thickness in the stomach wall. Gastric wall abscesses are very rare entities that must certainly be differentiated from malignancies. This rare infectious condition that has not been clearly defined in children in the literature can be treated by potent antibiotherapy without any invasive interventions

Anahtar Kelimeler

Abdominal pain, Abscess, Antibiotic, Children, Gastric

Kaynakça

• Marcos WC, Petrini BG, Xavier RL, Starling RM, Couto JC, Ribeiro GJ. Gastric wall abscess-an uncommon condition treated by an alternative form. Clinics (Sao Paulo) 2010;65:819-21.
• Khan M, Leya J, Dhillon S. An unusual case of recurrent gastric abscess. Gastroenterol Hepatol 2008;4:641-3.
• Kiil C, Rosenberg J. Gastric intramural abscess successfully drained during gastroscopy. Gastrointestinal Endoscopy 2001;53:231-3.
• Iwashima Y, Shibata N, Okada M, Yoshida T, Haneda M. A case of type 2 diabetes with a large abscess of the gastric wall successfully treated with a glycemic control and systemic antibiotics. Diabetes Res Clin Pract 2005;69:299-304.
• Asrani A, Novelline R, Abujudeh H, Lawrason J, Kaewlai R. Intramural gastric abscess—preoperative diagnosis with CT. Emerg Radiol 2007;14:253-6.
• Alonso JV, de la Fuenta Carillo JJ, Gutierrez Solis MA, Vara Morate FJ, Lopez Ruiz DJ. Gastric wall abscess presenting as thoracic pain: rare presentation of an old disease. Ann Gastroenterol 2013;26:360-2.
• Yang CW, Yen HH. Endoscopic sonography in the diagnosis and treatment of a gastric wall abscess: A case report and review of the literature. J Clin Ultrasound 2012;40:105-8.
• Dohi O, Dohi M, Inoue K, Gen Y, Jo M, Tokita K. Endoscopic transgastric drainage of a gastric wall abscess after endoscopic submucosal dissection. World J Gastroenterol 2014;20:1119-22.