Brusellozun nadir ve atipik sunumu: Akut batın

Akut batın cerrahi acil bir durumdur. Akut batının etyolojisinde çok çeşitli hastalıklar yer almaktadır. Nadiren de olsa enfeksiyoz hastalıklar da akut batın tablosuna neden olabilir. Bruselloz zoonotik bir hastalık olup, özellikle gelişmekte olan ülkeler için endemiktir. Ülkemizde de endemik olan bu hastalık önemli bir halk sağlığı sorunudur. Sıklıkla uzamış ateş kliniğine neden olan bu hastalık her türlü organı tutabilir. Tipik tutulumlar arasında kemik eklem tutulumu mevcutken, brusellozun birçok farklı atipik klinik sunumları da olabilir. Bu sunumlardan birisi de gastrointestinal tutulumlardır. Hastalık seyri sırasında retikülo-endoteliyal sistem organı olan karaciğer ve dalak tutulumu olsa da bunlar şiddetli karın ağrısına neden olmaz. Ancak hepatik apse, akut kolesistit, akut peritonit, akut pankreatit, kolit gibi tutulumlar şiddetli karın ağrısına ve hatta akut batına neden olabilir. Bu nedenle karın ağrısı ayırıcı tanısında özellikle endemik bölgelerde tanı konulamayan olgularda bruselloz düşünülmelidir. Bu hastalardan gerekli serolojik tetkikler istenmelidir. Ayrıca bu hastalara multidisipliner yaklaşım gerektiği unutulmamalıdır. Bu derleme çalışmasında brusellozun akut batındaki rolünü incelemeyi amaçladık.

Anahtar Kelimeler:

Bruselloz, akut kolesistit, akut peritonit, akut pankreatit, kolit, akut batın

A rare and atypic presentation of brusellosis: Acute abdomen

Acute abdominal surgery is an emergency. There are various diseases that are the etiology of acute abdomen. Rarely, infectious diseases can also cause acute abdomen. Brucellosis is a zoonotic disease, especially endemic to developing countries. This disease, which is also endemic in our country, is an important public health problem. This disease, which often causes prolonged fevers, can affect all kinds of organs. While bone-joint involvement is among the typical involvements, brucellosis can also have many different atypical clinical presentations. One of these presentations is gastrointestinal involvement. Although the liver and spleen, which are organs of the reticulo-endothelial system, are involved during the course of the disease, they do not cause severe abdominal pain. However, involvements such as hepatic abscess, acute cholecystitis, acute peritonitis, acute pancreatitis, and colitis may cause severe abdominal pain and even acute abdomen. Therefore, brucellosis should be considered in the differential diagnosis of abdominal pain, especially in cases where the diagnosis cannot be made in endemic regions. Necessary serological examinations should be done in these patients. In addition, it should not be forgotten that these patients require a multidisciplinary approach. In this review, we aimed to examine the role of brucellosis in acute abdomen.

Keywords:

acute cholecystitis, acute peritonitis, acute pancreatitis, colitis, acute abdomen, brucellosis,

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