Akut Karın Ağrısı ile Çocuk Acilde İzlenen Olguların Ayırıcı Tanısında Öykü ve Laboratuvar Tetkiklerin Önemi
Abstract
Amaç: Üç günden kısa süren akut karın ağrısı nedeniyle çocuk acilde gözleme alınan olguların sonuç tanılarının belirlenmesi, ayırıcı tanıda cerrahi karın olgularını öngörmede kullanılabilecek şikayet-tetkiklerin saptanması.Gereç ve Yöntemler: Ocak 2012 ile Aralık 2013 tarihleri arasındaki iki yıllık dönemde, Çocuk acil polikliniğinde akut karın ağrısı tanısı ile gözleme alınan, yaşları 2 ile 18 yıl arasında olan 250 olgu çalışmaya alındı. Olgular çıkış tanılarına göre dahili ve cerrahi nedenler olarak iki gruba ayrıldı. Bu iki grubun demografik özellikleri, şikayet, muayene ve laboratuvar bulguları karşılaştırıldı.Bulgular: Olguların % 80’ninde dahili nedenlere bağlı akut karın ağrısı, % 20 olguda cerrahi karın saptandı. Bu iki grup, ek bulgular açısından değerlendirildiğinde iki grup arasında istatistiksel fark saptanmadı (p=0,100). Cerrahi karın olgularında yaş ve lökosit sayı ortancası, lökositozu olan olgu sayısı daha yüksek saptandı (p<0,05).Sonuç: Akut karın ağrısı ile acil serviste gözleme alınan çocukların önemli bir kısmı cerrahi karın tanısı almaktadır. Ergen yaşlarda ve lökosit sayısı yüksek olan olgularda cerrahi karın olma riski açısından daha dikkatli değerlendirilme yapılması gerektiği düşüncesindeyiz.
Keywords
References
- Ötgün İ. Çocuklarda akut karın. İçinde: Karaböcüoğlu M, Yılmaz LH, Duman M (ed). Çocuk Acil Tıp. 1. baskı. İstanbul: İstanbul Tıp Kitapevi, 2012:1859-67.
- Liacouras CA. The digestive system. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF (eds). Nelson Textbook of Pediatrics. 19st ed. Philadelphia: Saunders Elsevier, 2011:1247-8.
- Stanley FL. Laboratory testing in infants and children. In: Kliegman RM, Stanton BF, St Geme JW, Schor FN (eds). Nelson Textbook of Pediatrics. 19th ed. Philadelphia: Saunders Elsevier, 2011:2466. Erişim: website, www.expertconsult.com. Erişim tarihi:10.03.2014.
- Elder JS. Urinary tract infections. In: Kliegman RM, Stanton BF, St Geme JW, Schor FN (eds). Nelson Textbook of Pediatrics. 19th ed. Philadelphia: Saunders Elsevier, 2011:1829-34.
- Taşar MA, Dallar Y, Şenol Z. Çocuklarda karın ağrısı nedenlerinin değerlendirilmesi. Gülhane Tıp Dergisi 2005;47:199-203.
- Mason JD. The evaluation of acute abdominal pain in children. Emerg Med Clin North Am 1996;14:629-43.
- Leung AKC, Sigalet DL. Acute abdominal pain in children. Am Fam Physician 2003;67:2321-7.
The Importance of the History and Laboratory Tests in the Differential Diagnosis of Acute Abdominal Pain Cases in the Pediatric Emergency Department
Abstract
Objective: The aim of this study was to determine the fi nal diagnosis of acute abdomen and verify the predictive physical examination fi ndings in the differential diagnosis of short-term (< 3 days) acute abdominal pain in patients seen in the pediatric emergency department.Material and Methods: A total of 250 patients aged between 2 and 18 years seen in the pediatric emergency department with acute abdominal pain from January 2012 to December 2013 were included in the study. The cases were divided into two groups according to medical or surgical causes of acute abdominal pain. The demographic data, symptoms, physical examination fi ndings, laboratory values, consultation results and fi nal diagnoses of the two groups were evaluated.Results: Acute abdomen was due to medical in 80% and surgical causes in 20% of the patients. There was no statistical difference between these groups regarding additional fi ndings (p=0.100). The median age, leukocyte count, and number of cases with leukocytosis were higher in the surgical abdomen group (p< 0.05).Conclusion: A signifi cant number of patients observed in the pediatric emergency department with acute abdominal pain have surgical abdomen. We believe that careful evaluation to detect surgical abdomen is essential for adolescent patients and also for patients that have high leukocyte counts
References
- Ötgün İ. Çocuklarda akut karın. İçinde: Karaböcüoğlu M, Yılmaz LH, Duman M (ed). Çocuk Acil Tıp. 1. baskı. İstanbul: İstanbul Tıp Kitapevi, 2012:1859-67.
- Liacouras CA. The digestive system. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF (eds). Nelson Textbook of Pediatrics. 19st ed. Philadelphia: Saunders Elsevier, 2011:1247-8.
- Stanley FL. Laboratory testing in infants and children. In: Kliegman RM, Stanton BF, St Geme JW, Schor FN (eds). Nelson Textbook of Pediatrics. 19th ed. Philadelphia: Saunders Elsevier, 2011:2466. Erişim: website, www.expertconsult.com. Erişim tarihi:10.03.2014.
- Elder JS. Urinary tract infections. In: Kliegman RM, Stanton BF, St Geme JW, Schor FN (eds). Nelson Textbook of Pediatrics. 19th ed. Philadelphia: Saunders Elsevier, 2011:1829-34.
- Taşar MA, Dallar Y, Şenol Z. Çocuklarda karın ağrısı nedenlerinin değerlendirilmesi. Gülhane Tıp Dergisi 2005;47:199-203.
- Mason JD. The evaluation of acute abdominal pain in children. Emerg Med Clin North Am 1996;14:629-43.
- Leung AKC, Sigalet DL. Acute abdominal pain in children. Am Fam Physician 2003;67:2321-7.
Details
| Other ID | JA49JE37NZ |
|---|---|
| Journal Section | Research Article |
| Authors | |
| Publication Date | April 1, 2015 |
| Submission Date | April 1, 2015 |
| Published in Issue | Year 2015 Volume: 9 Issue: 1 |
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