Çocuk acil kliniğinde abdominal ultrasonografisi istenen hastaların değerlendirilmesi
Küçük Resim Yok
Tarih
2024
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Çocuklarda akut karın ağrısı ani başlangıçlı ve acil müdahale gerektiren bir durumdur ve acil servislerde sık görülür. Erken tanı önemlidir; ancak belirsiz semptomlar, güvenilir öykü alınamaması ve atipik bulgular tanıyı zorlaştırabilir. Bu nedenle, ultrasonografi (USG) gibi görüntüleme teknikleri kullanılır. Bu çalışmada, çocuklarda akut karın durumlarında USG’nin tanısal etkinliği ve sık karşılaşılan akut karın ağrısı nedenlerini incelemeyi amaçladık.
Necmettin Erbakan Üniversitesi Tıp Fakültesi Çocuk Acil Kliniği'nde Ocak 2022- Aralık 2022 tarihleri arasında akut karın ağrısı olan ve abdomen USG istenen 504 çocuk (0-18 yaş) incelendi. Hastaların sosyodemografik bilgileri, başvuru şikayetleri, fizik muayene bulguları, laboratuvar sonuçları, başvuru saatleri, USG ve bilgisayarlı batın tomografi (BBT) bulguları, radyoloğun tecrübesi, konsültasyonlar, sevk ve cerrahi işlemler ile patolojinin ön tanı ile uyumu değerlendirildi.
Çalışmamızda, 504 hastanın yaş ortancası 9 yıl olup, %51'i erkek ve %49'u kızdı. Hastaların %46,6’sında spesifik olmayan karın ağrısı bulunurken, %53,4’ünde tanı konuldu. En sık tanılar mezenter lenfadenit ve gastroenteritti; en sık cerrahi tanı ise apandisitti. Abdominal USG'lerin %35,7’sinde patolojik bulgular gözlemlendi. Hastaların %17,3’üne BBT çekildi ve bunların %63,2’sinde patolojik bulgular saptandı. USG ile apandisit %6, normal apendiks %9,3 ve apendiks görüntülenememe %84,7 oranındadır. 49 hasta apandisit ön tanısıyla cerrahi işlem geçirdi ve negatif apendektomi oranı %6,1 bulundu. Apendektomi yapılan hastaların USG'lerinde %34,7 oranında apandisit görülmemiş, %4,1'inde apendiks çapı 6 mm'nin altında, %61,2'sinde ise 6 mm'nin üzerinde saptandı. Apandisit için USG'nin duyarlılığı %60,9, özgüllüğü %33,3, pozitif prediktif değer %93,3 ve negative prediktif değer %5,3 olarak bulundu. BBT'nin duyarlılığı ise %100 olarak belirlendi.
Sonuç olarak, abdominal USG’nin çocuklarda karın ağrısının değerlendirilmesindeki rolü belirgin şekilde önemlidir ve bu yöntem, acil durumlarda tanı sürecini iyileştirmek için etkili bir araç olarak kullanılmaktadır. Ancak, daha yüksek
kesinlik ve güvenilirlik sağlamak için multidisipliner bir yaklaşım ve çeşitli görüntüleme yöntemlerinin entegrasyonu gereklidir.
Acute abdominal pain in children is a condition that requires sudden onset and urgent intervention and is frequently seen in emergency departments. Early diagnosis is important; however, vague symptoms, lack of reliable history, and atypical findings can make diagnosis difficult. Therefore, imaging techniques such as ultrasonography (USG) are used. In this study, we aimed to examine the diagnostic efficacy of USG in acute abdomen conditions in children and the common causes of acute abdominal pain. A total of 504 patients (aged 0-18) who underwent abdominal ultrasound at the Pediatric Emergency Clinic of Necmettin Erbakan University Medical Faculty were studied between January 2022 and December 2022. The patients' sociodemographic information, complaints on admission, physical examination findings, laboratory results, admission times, USG and computed tomography (CT) findings, radiologist experience, consultations, referral and surgical procedures, and the compatibility of pathology with the preliminary diagnosis were evaluated. In our study, the median age of 504 patients was 9 years, 51% were male and 49% were female. While nonspecific abdominal pain was present in 46.6% of the patients, a diagnosis was made in 53.4%. The most common medical diagnoses were mesenteric lymphadenitis and gastroenteritis; the most common surgical diagnosis was appendicitis. Pathological findings were observed in 35.7% of abdominal USGs. Abdominal CT was performed in 17.3% of the patients and pathological findings were detected in 63.2% of them. Appendicitis was 6%, normal appendix was 9.3% and appendix could not be visualized was 84.7% with USG. 49 patients underwent surgery with a preliminary diagnosis of appendicitis and the negative appendectomy rate was found to be 6.1%. Appendicitis was not seen in 34.7% of the patients who underwent surgery in their USGs, appendix diameter was detected to be less than 6 mm in 4.1% and more than 6 mm in 61.2%. The sensitivity of USG for appendicitis was found to be 60.9%, specificity 33,3%, positive predictive value 93.3% and negative predictive value 5,3%. The sensitivity of CT was determined as 100%. In conclusion, the role of abdominal USG in the evaluation of abdominal pain in children is clearly important and this method is used as an effective tool to improve the diagnostic process in emergency situations. However, a multidisciplinary approach and integration of various imaging methods are required to provide higher accuracy and reliability.
Acute abdominal pain in children is a condition that requires sudden onset and urgent intervention and is frequently seen in emergency departments. Early diagnosis is important; however, vague symptoms, lack of reliable history, and atypical findings can make diagnosis difficult. Therefore, imaging techniques such as ultrasonography (USG) are used. In this study, we aimed to examine the diagnostic efficacy of USG in acute abdomen conditions in children and the common causes of acute abdominal pain. A total of 504 patients (aged 0-18) who underwent abdominal ultrasound at the Pediatric Emergency Clinic of Necmettin Erbakan University Medical Faculty were studied between January 2022 and December 2022. The patients' sociodemographic information, complaints on admission, physical examination findings, laboratory results, admission times, USG and computed tomography (CT) findings, radiologist experience, consultations, referral and surgical procedures, and the compatibility of pathology with the preliminary diagnosis were evaluated. In our study, the median age of 504 patients was 9 years, 51% were male and 49% were female. While nonspecific abdominal pain was present in 46.6% of the patients, a diagnosis was made in 53.4%. The most common medical diagnoses were mesenteric lymphadenitis and gastroenteritis; the most common surgical diagnosis was appendicitis. Pathological findings were observed in 35.7% of abdominal USGs. Abdominal CT was performed in 17.3% of the patients and pathological findings were detected in 63.2% of them. Appendicitis was 6%, normal appendix was 9.3% and appendix could not be visualized was 84.7% with USG. 49 patients underwent surgery with a preliminary diagnosis of appendicitis and the negative appendectomy rate was found to be 6.1%. Appendicitis was not seen in 34.7% of the patients who underwent surgery in their USGs, appendix diameter was detected to be less than 6 mm in 4.1% and more than 6 mm in 61.2%. The sensitivity of USG for appendicitis was found to be 60.9%, specificity 33,3%, positive predictive value 93.3% and negative predictive value 5,3%. The sensitivity of CT was determined as 100%. In conclusion, the role of abdominal USG in the evaluation of abdominal pain in children is clearly important and this method is used as an effective tool to improve the diagnostic process in emergency situations. However, a multidisciplinary approach and integration of various imaging methods are required to provide higher accuracy and reliability.
Açıklama
Anahtar Kelimeler
abdominal ultrasonografi, abdominal ultrasonography, akut karın ağrısı, acute abdominal pain, apandisit, appendicitis, çocuk acil, pediatric emergency
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Babayiğit, E. (2024). Çocuk acil kliniğinde abdominal ultrasonografisi istenen hastaların değerlendirilmesi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Tıp Fakültesi Dahili Tıp Bilimleri Bölümü Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, Konya.
