Kronik rekürren karın ağrılı çocuklarda abdominal migren prevalansının değerlendirilmesi
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Tarih
2023
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Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Abdominal migren, çocukların %0,2-4,1'ini etkileyen fonksiyonel karın ağrısı bozukluğudur. Abdominal migren klinik bir tanıdır.Hastanın işlevselliğini önemli ölçüde etkiler. Tedavi önleyici tedbirlere odaklanır ve çoğunlukla ilaç dışı yaklaşımları içerir.Çocuk gastroenteroloji polikliniğine kronik rekürren karın ağrısı ile başvuran çocuklarda abdominal migren sıklığını değerlendirmeyi amaçladık. Kronik karın ağrısı ile gelen hastalar için abdominal migrenin ayırıcı tanı olarak akla getirilmesine katkıda bulunmak istedik. Araştırmamız Kasım 2021 ile Kasım 2022 tarihleri arasında, Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi çocuk gastroenterolojisi polikliniğinde gerçekleştirilmiş prospektif kesitsel bir çalışmadır. Çocuk gastroenterolojisi polikliniğine kronik rekürren karın ağrısı yakınmasıyla başvuran 4-18 yaş arası hastalar dahil edilmiştir. Çalışmanın ilk altı ayında dahil edilme kriterlerini karşılayan hastalar, sonraki altı ayda takip edilerek nihai tanıları kesinleştirildi.Nihai tanılarına göre olgular abdominal migren grubu, abdominal migren dışı fonksiyonel gastrointestinal sistem hastalık grubu ve organik hastalık grubu olarak üç gruba ayrıldı. Gruplar demografik ve klinik özellikler, laboratuvar ve görüntüleme bulguları bakımından değerlendirildi. Dahil edilme kriterlerini karşılayan 160 hastanın %62,50'si (n=100) kız, %37,50'si (n=60) erkek ve yaş ortalaması 138,83±47,86 aydı (min=60, maks=216). Boy z-skoru ortalaması -0,21±0,08, ağırlıkz-skoru ortalaması -0,38±0,09 ve vücut kitle indeksi z-skoru-0,29 (-1,28 -0,69) [ortanca (Q1-Q3)] idi. Çocuk gastroenterolojisi polikliniğine kronik karın ağrısı yakınması ile başvuran hastaların %8,12'si (n=13) abdominal migren tanısı aldı. Hastaların %47,50'si (n=76)abdominal migren dışı fonksiyonel gastrointestinal hastalıklar grubunu ve %44,38'i (n=71)organik hastalık grubunu oluşturmaktaydı.Ağrının lokalizasyonu, abdominal migren dışı fonksiyonel gastrointestinal sistem hastalıkları grubunda sıklıkla periumblikal bölgede, organik hastalık grubunda ise epigastrik bölgedeydi ve fark istatistiksel olarak anlamlıydı (p=0,000). Karın ağrısının süresi abdominal migren grubunda, diğer iki gruptan istatistiksel olarak anlamlı derecede daha uzundu (p=0,001). Laboratuvar ve görüntüleme bulguları bakımından gruplar arasında istatistiksel olarak anlamlı fark izlenmedi. Organik hastalık grubundaki olguların %26,76'sının, abdominal migren dışı fonksiyonel gastrointestinal hastalık grubundaki olguların ise %14,47'sinin abdominal migren tanı kriterlerinin hepsini karşıladığı tespit edildi. Abdominal migren klinik bir tanıdır. Tanı için belirli bir laboratuvar testi ya da görüntüleme yöntemi yoktur. Bu nedenle kronik rekürren karın ağrısı varlığında abdominal migren ayırıcı tanı olarak akılda tutulmalıdır. Ancak abdominal migren tanı kriterlerini karşılayan olgularda da, diğer fonksiyonel gastrointestinal sistem hastalıkları ve özellikle organik hastalıkların ekarte edilmesi önemlidir.
Abdominal migraine is a functional abdominal pain disorder seen in 0,2% to 4,1% of children. We aimed to evaluate abdominal migraine, especially in children brought to the pediatric gastroenterology outpatient clinic with chronic recurrent abdominal pain. We wanted to contribute to the consideration of abdominal migraine as a differential diagnosis for patients presenting with chronic abdominal pain. Our research is a prospective cross-sectional study conducted in pediatric gastroenterology outpatient clinic in our hospital between November 2021 and November 2022. Patients aged 4-18 years who applied to the pediatric gastroenterology outpatient clinic with the complaint of chronic recurrent abdominal pain were included in the study. Patients who met the inclusion criteria in the first six months were followed up in the second six months and their definitive diagnosis was confirmed. The cases were divided into three groups according to their definitive diagnosis: abdominal migraine group, functional gastrointestinal system disease other than abdominal migraine group, and organic disease group. The groups were evaluated in terms of demographic and clinical characteristics, laboratory and imaging findings. Of 160 patients who met the inclusion criteria 62,50% (n=100) were female, and 37,50% (n=60) were male, with a mean age of 138,83 ± 47,86 (min=60, max=216). Height z-score means -0,21±0,08, weight z-score means -0,38±0,09, and body mass index z-score median value -0,29 and 1st quartile -1,28, 3rd quartile 0,69 calculated. The abdominal migraine group was 8,12% (n=13), the group of functional gastrointestinal diseases other than abdominal migraine group 47,50%(n=76), and the organic disease group was 44,38% (n=71). The localization of pain was in the periumbilical region in the abdominal migraine group and the organic disease group pain was mostly localized in the epigastric region; the difference was statistically significant (p=0,000). The duration of abdominal pain was statistically significantly longer in the abdominal migraine group than the other two groups (p=0,001). There was no statistically significant difference between the groups in terms of laboratory and imaging findings. It was determined that 26,76% of the cases in the organic disease group and 14,47% of the cases in the functional gastrointestinal disease group other than abdominal migraine met all criteria for abdominal migraine. Abdominal migraine is a clinical diagnosis. There is no specific laboratory test or imaging method for diagnosis. Therefore, abdominal migraine should be kept in mind as a differential diagnosis in the presence of chronic recurrent abdominal pain.
Abdominal migraine is a functional abdominal pain disorder seen in 0,2% to 4,1% of children. We aimed to evaluate abdominal migraine, especially in children brought to the pediatric gastroenterology outpatient clinic with chronic recurrent abdominal pain. We wanted to contribute to the consideration of abdominal migraine as a differential diagnosis for patients presenting with chronic abdominal pain. Our research is a prospective cross-sectional study conducted in pediatric gastroenterology outpatient clinic in our hospital between November 2021 and November 2022. Patients aged 4-18 years who applied to the pediatric gastroenterology outpatient clinic with the complaint of chronic recurrent abdominal pain were included in the study. Patients who met the inclusion criteria in the first six months were followed up in the second six months and their definitive diagnosis was confirmed. The cases were divided into three groups according to their definitive diagnosis: abdominal migraine group, functional gastrointestinal system disease other than abdominal migraine group, and organic disease group. The groups were evaluated in terms of demographic and clinical characteristics, laboratory and imaging findings. Of 160 patients who met the inclusion criteria 62,50% (n=100) were female, and 37,50% (n=60) were male, with a mean age of 138,83 ± 47,86 (min=60, max=216). Height z-score means -0,21±0,08, weight z-score means -0,38±0,09, and body mass index z-score median value -0,29 and 1st quartile -1,28, 3rd quartile 0,69 calculated. The abdominal migraine group was 8,12% (n=13), the group of functional gastrointestinal diseases other than abdominal migraine group 47,50%(n=76), and the organic disease group was 44,38% (n=71). The localization of pain was in the periumbilical region in the abdominal migraine group and the organic disease group pain was mostly localized in the epigastric region; the difference was statistically significant (p=0,000). The duration of abdominal pain was statistically significantly longer in the abdominal migraine group than the other two groups (p=0,001). There was no statistically significant difference between the groups in terms of laboratory and imaging findings. It was determined that 26,76% of the cases in the organic disease group and 14,47% of the cases in the functional gastrointestinal disease group other than abdominal migraine met all criteria for abdominal migraine. Abdominal migraine is a clinical diagnosis. There is no specific laboratory test or imaging method for diagnosis. Therefore, abdominal migraine should be kept in mind as a differential diagnosis in the presence of chronic recurrent abdominal pain.
Açıklama
Anahtar Kelimeler
Abdominal migren, Ağrı, Çocuk, Abdominal migraine, Pain, Child
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Künye
Paydaş. A. B. (2023). Kronik rekürren karın ağrılı çocuklarda abdominal migren prevalansının değerlendirilmesi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahili Tıp Bilimleri Bölümü Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, Konya.
