Hamza YAZGAN, Ömer ETLİK, Mehmet DEMİRDÖVEN, Mevlit KORKMAZ, Arzu GEBEŞCE, Feride KORKMAZ, Esengül KELEŞ, Kürşat BUDAN

Çocukluk çağı invajinasyon olgularında pnömatik redüksiyon sonuçları

Proksimal barsağın distal segment içerisine girmesi ile oluşan invajinasyon, çocuklarda akut batın nedenleri arasında apendisitten sonra ikinci sırada yer almaktadır. Çalışmamızda, invajinasyon nedeni başvuran hastalar ve pnömatik redüksiyon sonuçlarımız değerlendirilmiştir. Hastanemize 2007-2011 yılları arasında invajinasyon nedeniyle başvuran ve tedavi edilen hastaların, dosya ve operasyon kayıtları geriye dönük olarak incelendi. Çalışmamızda 13ü erkek (%72,2), 5i kız (%27,8) toplam 18 hasta değerlendirilmiştir. Olguların yaş ortalaması 20,36 aydır (6,5-95 ay). Hastaların en sık başvuru şikayetleri karın ağrısı, kusma, kanlı gaita yapma ve huzursuzluk olup, şikayetlerin başlangıcı 6-52 saattir. Tüm hastaların ultrasonografik incelemesinde invajinasyon bulgusu saptanmasına rağmen 8 (%44) hastanın batın muayenesinde kitle ele gelmiş. Hastaların 15inde (%83,3) floroskopi eşliğinde pnömatik redüksiyon yapılmış, 3 (%16,7) hastada ise açık cerrahi yöntemle manüel redüksiyon yapılmıştır. Sonuç olarak, karın ağrısı ve kusma şikayetleri ile gelen çocuklarda sık yapılan batın ultrasonografisi, invajinasyonun erken tanısında etkili olmaktadır. Bu vakalarda, pnömatik redüksiyon ilk tedavi seçeneği olarak, kolay ve başarıyla uygulanabilir.

Pneumatic reduction in the treatment of childhood intussusception cases

Intussusception that is defined as insertion of proximal intestine into distal segment is the second most common acute abdomen pathology after appendicitis. In this retrospective study, we evaluated the patients presented with intussusception and the results of pneumatic reduction. A retrospective analysis of files and operation logs of patients with intussusception from 2007 to 2011 were done. In this study, 13 male (72,2%) and 5 female (27,8%), totally 18 patients were analyzed. Mean age was 20,36 months (6,5-95 months). The most common clinical presentations were abdominal pain, vomiting, bloody stool and irritability and duration of complains were 6-52 hours. Although in all patients signs of intussusception were found on abdominal ultrasound examination, in 8 (44%) patients abdominal mass was detected on physical examination. In 15 (83,3%) patients pneumatic reduction was successfully performed and manual reduction was done in 3 (16,7%) patients. In conclusion, abdominal ultrasound that was performed in patients presented with abdominal pain and vomiting may affect the rate of early diagnosis of intussusception. In these patients, pneumatic reduction, as a first choice of treatment, can be carried out easily and successfully.

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