Pediatrik apandisit olgularında ultrasonografinin tanısal duyarlılığı

Amaç: Bu çalışmada pediatrik yaş grubunda ultrasonografinin apandisit tanısındaki duyarlılığının araştırılması amaçlanmıştır. Yöntem: Operasyon sonucu apandisit tanısı alan, preoperatif USG tetkiki gerçekleştirilmiş olan ve akut batın sebebi olabilecek ek patolojisi bulunmayan 87 pediatrik olgu çalışmaya dahil edildi. Olguların USG raporları retrospektif olarak incelenerek USG’ nin apandisit tanısındaki duyarlılığı araştırıldı. Ayrıca olguların lökosit sayıları, nötrofil oranları ve CRP değerleri hastane arşivinden ve varsa BT tetkikleri PACS sisteminden incelendi. Bulgular: Olguların % 71’i akut apandisit, %29’u perfore apandisitti. Olguların %74’ünün USG’si apandisit ile uyumlu olup USG’nin tanı duyarlılığı %74’dü, %16 olguda USG’de sekonder apandisit bulguları izlenirken %10 olguda USG tetkiki tamamen normaldi. USG ile tanı konulamayan %26 olgudan %10’unun tanısı BT ile konulmuştu. %16 olguda tanıya klinik bulgularla gidilmişti. Olguların %62’sinde lökositoz, %84’ünde nötrofil oranında artış (sola kayma), %86’sında ise CRP yüksekliği bulunmaktaydı ve olguların tamamında bu parametrelerin en az biri yüksekti. Sonuç: Ultrasonografi her durumda tanı koymak için yeterli olmasa da bu çalışmada ulaşılan yüksek duyarlılık oranı, ultrasonografinin akut apandisit şüphesi bulunan pediatrik hastalarda ilk seçenek tanı aracı olarak kullanılabileceği bilgisini desteklemektedir.

Anahtar Kelimeler:

Apandisit, Ultrasonografi, Pediatrik

Diagnostic sensitivity of ultrasonography in pediatric appendicitis cases

Objective: In this study, it was aimed to investigate the sensitivity of ultrasonography in the diagnosis of appendicitis in the pediatric age group. Method: 87 pediatric cases who were diagnosed with appendicitis after the operation, had preoperative USG examination and had no additional pathology causing acute abdomen were included in the study. The sensitivity of USG in the diagnosis of appendicitis was investigated by examining the USG reports of the cases retrospectively. In addition, the leukocyte counts, neutrophil ratios and CRP values of the cases were analyzed from the hospital archive and CT examinations, if any, from the PACS system. Results: 71% of the cases were acute appendicitis, 29% of them were perforated appendicitis. USG was compatible with appendicitis in 74% of the cases, and the diagnostic sensitivity of USG was 74%. Secondary appendicitis findings were observed on USG in 16% of the cases, while USG was completely normal in 10% of the cases. Of the 26% cases that could not be diagnosed by USG, 10% of the cases were diagnosed by CT. The diagnosis was made by clinical findings in 16% of the cases. There was leukocytosis in 62% of the cases, an increase in the neutrophil ratio (shift to the left) in 84%, and elevated CRP in 86%, and at least one of these parameters was high in all cases. Conclusion: Although ultrasonography is not sufficient to diagnose in all cases, the high sensitivity rate achieved in this study supports the knowledge that ultrasonography can be used as a first-choice diagnostic tool in pediatric patients with suspected acute appendicitis

Keywords:

Appendicitis, Ultrasonography, Pediatric,

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