Dilan ALTINTAŞ URAL, Ali Erdal KARAKAYA, Ahmet Gökhan GÜLER, Hatice Sonay YALÇIN, Mustafa TUŞAT

Koronavirüs-19 Pandemisi Öncesi ve Sırasında Çocuklarda Akut Apandisit Yönetiminin Karşılaştırmalı Analizi

Amaç: Koronavirüs-19 (COVID-19) salgınında pek çok hastalığın tanı ve tedavisinde gecikme olmuştur. Bu çalışmanın amacı COVID-19 salgını öncesinde ve sırasında akut apandisit (AA) insidansını ve şiddetini karşılaştırmaktır. COVID-19 salgınının apandisit hasta sayısı ve komplikasyonları üzerindeki etkisini araştırmaktır. Gereç ve Yöntemler: Bu çok merkezli çalışma üç tıp fakültesi hastanesinde 15 Mart-30 Haziran 2019 tarihi ile pandemi dönemi olan 15 Mart–30 Haziran 2020 tarihleri arasında retrospektif olarak yapıldı. İki grup oluşturuldu. Grup A, 2019 yılında acile karın ağrısı nedeniyle başvuran 1655 hastadan (64 hasta AA tanılı) oluşurken, Grup B pandemi döneminde karın ağrısı ile acile başvuran 1120 hastadan (77 hasta AA tanılı) oluşmaktadır. Her gruptaki hastaların klinikopatolojik özellikleri arasında karşılaştırma yapıldı. Bulgular: Acil servise karın ağrısı nedeniyle başvuran hastalar, akut ve komplike apandisit olarak değerlendirildi. Grup A’de toplam karın ağrısı ile başvuran 1655 hastanın 64’ü(%3.86) apandisit tanısı alırken, Grup B’de 1120 hastanın 77’si (%6.87) apandisit olmak üzere toplam 141 hastaya apandisit teşhisi konuldu. Grup A 64 apandisit hastasının 52’si (%81) akut apandisit, 12’si (%18.75) komplike apandisit, Grup B ‘de 77 hastanın 47’si (%61) akut apandisit, 30’u (%38.9) komplike apandisit olarak değerlendirildi. Sonuç: Akut pandemik dönemde karantina dışı döneme göre daha az hasta başvurdu ama yüksek oranda apandisit tanısı konmuştur. COVID‐19 döneminde, daha fazla apandisit hastası hastalığın geç evresinde başvurmuştur. Vakalarımızda pandemi döneminde komplike apandisit oranının yüksek olmasının, COVİD-19 salgını nedeniyle gecikmiş tanı sebebiyle olduğuna inanıyoruz.

Anahtar Kelimeler:

apandisit, covid-19, komplike apandisit

Comparative Analysis of the Acute Appendicitis Management in Children before and During the Coronavirus Disease-19 Pandemic

Objective: Acute appendicitis (AA) is one of the most common surgical emergency in pediatric population. Herein, we aimed to compare the incidence and severity of AA before and during the Coronavirus Disease-19 (COVID-19) outbreak. Materials and Methods: This multicenter study was conducted in three medicine faculty hospitals between the periods of 15 March-30 June 2019 (Group A), and the pandemic period of 15 March-30 June 2020 (Group B). We evaluated the clinicopathological characteristics of the patients in each group in terms of age, gender, serum leukocyte, C-reactive protein, radiological imaging use of postoperative peritoneal drain and presence of serious complications. Results: A total of 141 patients were identified and divided into two groups as Group A (n=64) and Group B (n=77). We found higher complication rates in Group B. Fewer patients applied in Group B, but a higher rate of AA was diagnosed. During the COVID-19 period, more patients were admitted with the later stages of the AA and with significant complications. Radiological imaging of patients with appendicitis in Group B showed more severe findings compared to Group A. Conclusion: Higher rate of perforated and complicated appendicitis in the pandemic period was due to misdiagnosis/delayed diagnosis in primary care centers as a result of fear from contagious coronavirus. Although the period of the COVID -19 pandemic brings out difficulties in treatment of patients, comprehensive assessment and physical examination in children with suspected surgical conditions should always be emphasized.

Keywords:

appendicitis, COVID – 19, complicated appendicitis.,

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