Mehmet Tolga Kafadar, Gürkan Değirmencioğlu, Tuğba Çaviş

Nadir Bir Akut Karın Nedeni: Primer Apendajitis Epiploika; Tomografinin Etkinliği

Primer apendajitis epiploika (PAE), nadir görülen ve kolonun epiploik apendikslerinin enflamasyonu sonucu oluşan klinik bir tablodur. Konservatif tedavinin genellikle yeterli olması sebebiyle, acil cerrahi müdahale gerektiren ve benzer klinik bulgular gösteren diğer akut abdominal ağrı nedenlerinden ayırımı yapılmalıdır. Özellikle karın sol ve sağ alt kadranlarda ortaya çıkan akut ağrı tablolarında, PAE akılda tutulmalıdır. Tanıda bilgisayarlı tomografi, en etkin ve kesin sonuç veren radyolojik görüntüleme yöntemi olarak kullanılmaktadır. Bu sayede, gereksiz acil cerrahi müdahaleden kaçınılmış olur. Bu yazıda, akut karın bulguları veren, bilgisayarlı tomografi ile kesin tanı alan ve konservatif yöntemlerle tedavi edilen, nadir bir olgu sunuldu.

Anahtar Kelimeler:

Akut karın, Apendajitis, Tomografi

A Rare Cause Of Acute Abdomen: Primary Epiploic Appendagitis; Effectiveness Of Tomography

Primary epiploic appendagitis (PEA) is a rare clinical presentation of the inflammation of colonic epiploic appendixes. It shoud be differentiated from other acute abdominal pain causes with similar symptoms which may need urgent surgery because it is self-limiting and usually can be treated conservatively. PEA shoud be kept in mind especially in cases with acute pain of the lower right and left quadrants. Computed tomography is the most specific and definite radiologic screening method used to diagnose PEA which prevents the patient from unnecessary urgent surgical intervention. Herein, we present a rarely seen case of PEA which was diagnosed via computed tomography and treated conservatively with acute abdomen symptoms.

Keywords:

Acute abdomen, Appendagitis, Tomography,

PDF

___

1. Legome EL, Belton AL,Murray RE, et al. Epiploic appendagitis: the emergency department presentation. J Emerg Med 2002;22(1):9-13.
2. Rioux M, Langis P. Primary epiploic appendagitis: clinical, US, and CT findings in 14 cases. Radiology 1994;191(2):523-26.
3. Sirvanci M, Tekelioğlu MH, Duran C, et al. Primary epiploic appendagitis: CT manifestations. Clin Imaging 2000;24(6):357-61.
4. Birjawi GA, Haddad MC, Zantout HM, et al. Primary epiploic appendagitis: a report of two cases. Clin Imaging 2000;24(4):207-9.
5. Sand M, Gelos M, Bechara FG, et al. Epiploic appendagitis: clinical characteristics of an uncommon surgical diagnosis. BMC Surg 2007;1(7):7-11.
6. vanBredaVriesman AC, Puylaert JB. Epiploic appendagitis and omentalin farction: pitfall sandlookalikes. Abdom Imaging 2002;27(1):20-8.
7. Singh AK, Gervais DA, Hahn PF, et al. Acute Epiploic Appendagitis and Its Mimics. Radiographics 2005;25(6):1521-34.
8. Schnedl WJ, Tillich M, Lipp RW. Image of the month. Primary epiploic appendagitis. Clin Gastroenterol Hepatol 2010;8(2):A16.
9. Bonnefoy S, Corberand D, Sinayoko L, et al. Epiploic appendagitis: report of a case. Gastroenterol Clin Biol 2008;32(12):1092-94.