İlknur BANLI CESUR, Zerrin ÖZÇELİK, Selçuk MATYAR, Günay EKBERLİ

Apandisit Ayırıcı Tanısında İmmatür Granülosit Sayısının ve Yüzdesinin Rolü

Amaç: Akut apandisit, çocuk cerrahisi pratiğinde en önemli ve yaygın olarak uygulanan acil cerrahilerden biridir. Çocuklarda apandisit tanısı yetişkinlere göre daha zordur. Olgunlaşmamış granülosit yüzdesi (%IG) son zamanlarda erişkin popülasyonda inflamasyon şiddetinin saptanması için laboratuvar parametresi olarak araştırılmaktadır. Çalışmanın amacı, pediatrik akut apandisit erken tanısında IG sayısı ve yüzde rolünün belirlenmesidir. Gereç ve Yöntemler: Ocak 2021-Aralık 2022 tarihleri arasında karın ağrısı şikayeti ile Acil Servise başvuran ve preoperatif akut apandisit tanısı ile opere edilen hastaların verileri hastane kayıtlarından geriye dönük olarak incelendi. 18 yaş altı, akut apandisit ön tanısı ile ameliyat edilen ve hemogramı olan hastalar çalışmaya dahil edildi. Bulgular: Çalışmaya 108 hasta dahil edildi. Akut apandisit grubunda 48 hasta, perfore apandisit grubunda 9 hasta ve kontrol grubunda 53 hasta vardı. Apandisit ve kontrol grubundaki hastalarda ortalama IG %’si sırasıyla 0.31±0.37 ve 0.96±5.1 idi. Apandisit hastaları ile kontrol grubu arasında IG sayısı ve yüzdesi açısından anlamlı fark bulunmadı. Akut ve perfore apandisit arasında IG sayısı ve IG % açısından istatistiksel olarak anlamlı fark bulunmadı. Sonuç: IG sayısı ve IG%, herhangi bir ek fayda sağlamadı ve klinisyen için akut apandisit belirlemede kesin bir biyobelirteç değildir. Akut apandisit tanısı için anamnez, fizik muayene ve laboratuvar testinin bir kombinasyonu altın standart olmaya devam etmektedir.

Anahtar Kelimeler:

acute appendicitis, immature granulocyte, pediatrcis

Role of Immature Granulocyte Count and Percentage in The Differential Diagnosis of Appendicitis

Objective: Acute appendicitis is one of the most important and widely performed emergent surgery in pediatric surgery practice. Diagnosis of appendicitis in children is more challenging compared to adults. The immature granulocyte percentage (IG%) is recently investigated laboratory parameter for detection of inflammation severity in adult population . The aim of the study was determination of IG count and percentage role in early detection of pediatric acute appendicitis. Materials and Methods: The data of patients who applied to Emergency Room with the complaint of abdominal pain and who were operated with a pre-operative diagnosis of acute appendicitis between January 2021 and December 2022 retrospectively reviewed from hospital records. Patients under 18 years, operated due pre-operative diagnosis of acute appendicitis and who have hemogram included in the study. Results: One hundred eight patients included in the study. Fourty-eight patients were in the acute appendicitis group, 9 patients were in the perforated appendicitis group, and 53 patients were in the control group. The mean IG % of was 0.31±0.37 and 0.96±5.1 in appendicitis and control group patients, respectively. No significant difference was found between appendicitis patients and control group in terms of IG number and percentage. No statistically significant difference was found between acute and perforated appendicitis in terms of IG number and IG%. Conclusion: IG number and IG% did not provide any additional benefit and is not a conclusive biomarker for clinician in determination of acute appendicitis. A combination of anamnesis, physical examination and laboratory test remains gold standard for diagnosis of acute appendicitis.

Keywords:

immature granulocyte, pediatrcis, acute appendicitis,

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