Karın ağrısı nedeni ile Çocuk Gastroenteroloji ve Çocuk Romatoloji polikliniklerine yönlendirilen hastaların özellikleri

Year 2023, Volume: 6 Issue: 2, 235 - 241, 30.06.2023

Nihal Şahin , Nilüfer Ülkü Şahin

https://doi.org/10.53446/actamednicomedia.1221481

Abstract

Amaç
Çocukluk çağında en sık hastane başvuru nedenlerinden biri karın ağrısıdır. Amacımız genel pediatri polikliniklerinden karın ağrısı nedeniyle çocuk gastroenteroloji ve romatoloji polikliniklerine yönlendirilen hastaların özelliklerini değerlendirmektir.
Yöntem
Karın ağrısı nedeni ile genel pediatri polikliniklerinden Çocuk Gastroenteroloji veya Çocuk Romatoloji polikliniklerine yönlendirilen hastalar elektronik sistemden tarandı. Çalışmaya başvuru dışında en az 1 kez kontrol vizit yapılmış, 18 yaş altı hastalar dahil edildi. Dahil edilen hasta sayısı 209’du. Hastaların klinik özellikleri, laboratuvar sonuçları, son tanıları ve tedavileri yönlendirilen kliniğe göre incelendi.
Bulgular
Hastaların yaş ortalaması 10,95±4,73 yıl ve median 11 yıl (1,42-18 yıl) idi. Hastaların 115’i (%55) kızdı. Karın ağrısı başlangıç süresi medyan değeri 12 aydı ve 5 gün-10 yıl arasındaydı. 117 hasta (%56) yalnızca çocuk gastroenteroloji polikliniğine, 43 hasta (%20,6) yalnızca Çocuk Romatoloji polikliniğine, 49 hasta (%23,4) ise her ikisine yönlendirilmişti. Hastaların 125’inde (%59,8) karın ağrısı her gündü ve 106’ında (%50,7) ağrı 1 saatten kısa süreliydi. Ağrı 86’ında (%41,1) yaygın, 67’inde (%32,1) periumblikal, 36’ında (%17,2) epigastrik yerleşimliydi. En sık eşlik eden semptom 94’ünde (%45) yemeklerle artan ağrıydı. Ateş, eklem bulgusu, döküntü, miyalji, oral aft, tonsilit, ailede ailevi Akdeniz ateşi (AAA) varlığı yalnızca Çocuk Gastroenteroloji polikliniğine yönlendirilen anlamlı olarak azdı (p<0,05). Konulan tanılar 56’ında (%26,8) iritable barsak sendromu (İBS), 44’ünde (%21,1) AAA, 44’ünde (%21,1) gastrit, 37’inde (%17,7) kabızlık, 30’unda (%14,4) gastroözefageal reflüydü (GÖRH) ve 29’unda (%13,9) patoloji saptanmadı.
Sonuç
Karın ağrısı nedeni ile Çocuk Gastroenteroloji ve Çocuk Romatoloji polikliniklerine yönlendirilen hastalarda başlıca saptanan hastalıklar İBS, AAA, gastrit, kabızlık, GÖRH idi. Hastaların yarısından fazlasında genel pediatri kliniklerinde takip edilebilecek hastalıklar mevcuttu.

Keywords

abdominal pain, familial Mediterranean fever, functional gastrointestinal disorders, pediatric, referrals clinics

Characteristic of patients with abdominal pain referred to pediatric gastroenterologist and pediatric rheumatologist

Abstract

Objective
We aim to investigate the characteristics of patients with abdominal pain who were referred from general pediatric to pediatric gastroenterology and rheumatology.
Methods
We searched patients with abdominal pain who were referred from general pediatric to pediatric gastroenterology and rheumatology in the registry system. Under 18 years, patients whose at least one visit was done after the first admission were included. The number of patients is 209. We assessed clinical characteristics, laboratory results, final diagnoses, and treatments according to admission to subdivision clinics.
Results
The mean age was 10.95±4.73 years, and the median was 11 years ( 1.42-18 ). One hundred fifteen(55%) were girls. The duration of onset of abdominal pain was between 5 days and ten years; its median was 12 months. The number of patients who were referred only to pediatric gastroenterology was 117(56%), to pediatric rheumatology was 43(20.6%), and to both clinics was 49(23.4%). Abdominal pain was lasting every day in 125(59.8%), and episode duration was less than one hour in 106(50.7%). The location of pain was generalized in 86(41.1%), periumbilical in 67(32.1%), and epigastric in 36(17.1%). The most common accompanying symptom was meal-related pain in 94(45%). Fever, joint findings, rashes, myalgia, oral aphthae, tonsillitis, and familial Mediterranean fever (FMF) in the family were significantly less in referred to pediatric gastroenterology (p<0.05). The diagnosis was irritable bowel syndrome (IBS) in 56(26.8%), FMF in 44(21.1%), gastritis in 44(21.1%), constipation in 37(17.7%), gastroesophageal reflux disease (GERD) in 30(14.4%), and no pathology in 29(13.9%).
Conclusion
The most common diagnoses were IBS, FMF, gastritis, constipation, and GERD, and almost half of the patients had diagnoses that could follow in general pediatrics.

Keywords

abdominal pain, familial Mediterranean fever, functional gastrointestinal disorders, pediatric, referrals clinics

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