AHMET UYANIKOĞLU, Hüseyin DURSUN, ÇİĞDEM CİNDOĞLU, HACER UYANIKOĞLU, Necati YENİCE

Şanlıurfa Yöresi Asitli Hastaların Değerlendirilmesi

Giriş ve Amaç: Asit tetkik nedeniyle takip edilen hastaların demografik, klinik, laboratuvar ve etiyolojik özelliklerinin araştırılması amaçlanmıştır. Gereç ve Yöntem: Araştırmaya Ocak 2013- Ekim 2014 döneminde ilk defa asit tespit edilen veya daha önce tanı konulan, dosyalarında yeterli veri bulunan hastalar dahil edilmiştir. Bulgular: Gastroenteroloji kliniğine asit tetkik nedeni ile yatırılan veya takip edilen 142 hastanın 65’i (%46) erkek, yaş ortalaması 58.4±16 yaş (dağılım 16-89) idi. Hastaların 114’ünde (%80) portal asit, 28’inde (%20) non portal asit saptandı. Tüm asit nedenlerinde (%68) ve portal tip asitte (%85) en sık neden karaciğer sirozu idi. Sirotik hastalardan 3 tanesinde hepatosellüler kanser, 1 tanesinde B hücreli lenfoma saptandı. Diğer portal tip asit nedenleri; 4 kardiyojenik, 4 kronik böbrek yetmezliği, 3 hasta Budd-Chiari, 2 kısa barsak sendromuna bağlı hipoalbüminemi, 1 portal tromboz, 1 hipotroidi, olarak saptandı. Non portal tip asit nedenleri ise 10 hastada (%7) primeri belli olmayan peritoneal karsinomatoz, 6 (%4) over kanseri, 5 (%3) tüberküloz peritonit, 2 mide kanseri, birer hastada periampüller kanser, kist hidatik rüptürü, endometrium kanseri, nefrotik sendrom ve ameliyat sonrası safra kaçağına bağlı asit idi. Sonuç: Asitli hastaların yaklaşık %80’i portal hipertansif tip asit olup tüm asit nedenleri ve portal hipertansif asitte en sık neden siroz olarak bulundu. Non portal asitte en sık neden malignite olup hastaların yaklaşık üçte ikisinden sorumlu, ikinci en sık neden ise tüberküloz peritonit idi.

Anahtar Kelimeler:

Asit, siroz, malignite, tüberküloz

Evaluation of patients with ascites in the Şanlıurfa Region

Background and Aims: This study aimed to evaluate patients with ascites who were followed to investigate their demographic, clinical, laboratory, and etiological features. Materials and Methods: The study was conducted from January 2013 to October 2014, and included patients with ascites that was detected for the first time before or diagnosed during this period. Patients with sufficient data in their files were included. Results: Examinations were conducted by the gastroenterology clinic because of ascites. This study included 142 patients, 65 (46%) were male and had a mean age of 58.4±16 years (range, 16-89 years). Also, 114 patients (80%) had portal ascites, whereas 28 (20%) had non-portal ascites. All-cause ascites (68%) and portal-type ascites (85%) were the most common causes of liver cirrhosis. Three cirrhotic patients had hepatocellular carcinoma and B cell lymphoma was detected in 1 patient. Other causes of portal ascites were cardiogenic in 4 patients, chronic kidney failure in 4 patients, Budd-Chiari in 3 patients, short bowel syndrome due to hypoalbuminemia in 2 patients, portal vein thrombosis in 1 patient, hypothyroidism in 1 patient. Causes of non-portal type ascites were in peritoneal carcinomatosis 10 patients (7%), ovarian cancer in 6 patients (4%), peritoneal tuberculosis in 5 patients (3%), gastric cancer in 2 patients, one in a patient with periampullary cancer, cyst rupture, endometrial cancer, nephrotic syndrome and postoperative biliary leakage was ascites. Conclusion: Approximately 80% of patients with ascites have portal hypertensive-type ascites. It is the most common cause of both cirrhosis and portal hypertension. Non-portal ascites is the most common malignancy and occurs in about two-thirds of patients, whereas the second reason is peritoneal tuberculosis.

Keywords:

Ascites, cirrhosis, malignancy, tuberculosis,

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