Hasan SULTANOĞLU, Ayça ÖZEL, Seda ÖZKAN, Tuba ERDEM SULTANOĞLU

İzole hiperbilirubinemi ile başvuran akut apandisit olgusu

Akut apandisit hastalarında, sarılık ve yaygın karın ağrısı nadir görülen bulgulardır. Çoğunlukla geç dönemde başvuran komplike ve perfore/gangrenöz apandisit ile ilişkilendirilir. Sarılığa neden olan hiperbilirübineminin yaygın nedenleri; genetik hastalıklar, enfeksiyonlar, karaciğer ve safra kesesi hastalıkları, toksinler ve kalp yetmezliğidir. Karaciğer enzim seviyesinin normal olduğu hiperbilirubinemi ise sepsis, sistemik enfeksiyon, metabolik hastalıklar ve gebelikte görülebilir. Bilirübin düzeyi acil serviste ulaşımı ve değerlendirilmesi kolay bir laboratuvar parametresidir. Acil servise akut sarılık ile başvuran hastalarda izole hiperbilirubinemi tespit edildiğinde akut apandisit ön tanısı da akılda tutulmalıdır.

A case of acute appendicitis admitted with isolated hyperbilirubinemia

Jaundice and diffuse abdominal pain are rare findings in patients with acute appendicitis and generally due to complicated late term of appendicitis such as perforated/gangrenous appendicitis. The common causes of hyperbilirubinemia which leads to jaundice are genetic disorders, infections, diseases of liver and gall bladder, toxins and heart failure. Hyperbilirubinemia with normal levels of liver enzymes could be the result of sepsis or systemic infections, metabolic disorders or pregnancy. Bilirubin levels could be easily detected in the emergency department. Acute appendicitis should be also kept in mind when isolated hyperbilirubinemia is detected in patients presenting with acute jaundice in the emergency department.

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