Acil Servise Karın Ağrısı ile Başvuran Hastada Akla Getirilmesi Gereken Bir Tanı: Primer Epiploik Apandisit

Yıl 2022, Cilt: 4 Sayı: 2, 87 - 89, 01.07.2022

Ece Yiğit , Tuba Mert , Melike Rusen Metin

https://doi.org/10.38175/phnx.1012708

Öz

Primer epiploik apandisit (PAE); kolonun mekanik koruma ve peristatik harekete yardımcı olmak ile görevli epiploik apendikslerinin torsiyonu, infarktı ve inflamasyonu sonucu ortaya çıkmaktadır. Fizik muayene ve laboratuar bulguları ile acil cerrahi müdahale gerektiren çeşitli akut karın tablolarını taklit etmekle birlikte sıklıkla medikal tedavinin yeterli ve başarılı olduğu benign seyirli bir hastalıktır. Gereksiz cerrahi müdahalelerin önlenmesi için hızlı ve doğru tanı önemlidir. Tanıda tomografi altın standarttır. Olgu sunumumuzda karın ağrısı ve bulantı ile acil servisimize başvuran PAE tanısı koyduğumuz ve konservatif yöntemler ile başarı ile tedavi edilmiş bir hastamız ele alınmıştır.

Anahtar Kelimeler

Karın ağrısı, Akut karın, Primer Epiploik Apandisit

A Diagnosis That Should be Considered in Patients Coming to The Emergency with Abdominal Pain: Primary Appendagitis Epiploica

Öz

Primary appendagitis epiploica (PAE) occurs as a result of torsion, infarction and inflammation of the epiploic appendages of the colon, which are responsible for mechanical protection and assisting peristatic movement. With physical examination and laboratory findings, it can imitate various acute abdomen conditions that require urgent surgical intervention. It is a benign disease in which medical treatment is often sufficient and successful. Prompt and accurate diagnosis is important to prevent unnecessary surgical interventions. Tomography is the gold standard in diagnosis. In our case report, a patient who applied to our emergency department with abdominal pain and nausea, diagnosed with PAE and successfully treated with conservative methods is discussed.

Anahtar Kelimeler

Stomachache, Acute abdomen, Primary appendagitis epiploica

Kaynakça

• Giannis D, Matenoglou E, Sidiropoulou MS, Paralampros A, Schmitz R, Felekouras E, et al. Epiploic appendagitis: pathogenesis, clinical findings and imaging clues of a misdiagnosed mimicker. Ann Transl Med. 2019;(7):814.
• Ozdemir S, Gulpinar K, Leventoglu S, Uslu HY, Turkoz E, Ozcay N, et al. Torsion of the primary epiploic appendagitis: a case series and review of the literature. Am J Surg. 2010;199:453-458.
• Ergelen R, Asadov R, Özdemir B, Tureli D, Demirbaş BT, Tuney D. CT findings of primary epiploic appendagitis as an easily misdiagnosed entity. Ulus Travma Acil Cerrahi Derg 2017;23(6):489–494.
• Barbier C, Denny P, Pradoura JM, Bui P, Rieger A, Bazin C, et al. Radiologic aspects of infarction of the appendix epiploica. J Radiol. 1998; 79:1479-1485.
• Golash V, Willson PD. Early laparoscopy as a routine procedure in the management of acute abdominal pain: A review of 1320 patients. Surg Endosc. 2005;19:882-885.
• van Breda Vriesman AC, Puylaert JB. Epiploic appendagitis and omental infarction: pitfalls and look-alikes. Abdom Imaging. 2002;27:20-8.
• de Brito P, Gomez MA, Besson M, Scotto B, Huten N, Alison D. Frequency and epidemiology of primary epiploic appendagitis on CT in adults with abdominal pain. J Radiol. 2008;89:235-243.
• Son HJ, Lee SJ, Lee JH, Kim JS, Kim YH, Rhee PL, et al. Clinical diagnosis of primary epiploic appendagitis: differentiation from acute diverticulitis. J Clin Gastroenterol. 2002;34:435-438.
• Sand M, Gelos M, Bechara FG, Sand D, Wiese TH, Steinstraesser L, et al. Epiploic appendagitis--clinical characteristics of an uncommon surgical diagnosis. BMC Surg 2007;7:11.
• Blinder E, Ledbetter S, Rybicki F. Primary epiploic appendagitis. Emerg Radiol. 2002;9:231-3.
• Legome EL, Belton AL, Murray RE, Rao PM, Novelline RA. Epiploic appendagitis: the emergency department presentation. J Emerg Med. 2002; 22:9-13.
• Singh AK, Gervais DA, Hahn PF, Sagar P, Mueller PR, Novelline RA. Acute epiploic appendagitis and its mimics. Radiographics. 2005;25:1521-1534.
• Lee YC, Wang HP, Huang SP, Chen YF, Wu MS, Lin JT. Gray-scale and color Doppler sonographic diagnosis of epiploic appendagitis. J Clin Ultrasound. 2001;29:197-199.
• Sirvanci M, Tekelioğlu MH, Duran C, Yardimci H, Onat L, Ozer K. Primary epiploic appendagitis: CT manifestations. Clin Imaging. 2000; 24:357-361.
• Buresh CT, Graber MA. Unusual causes of recurrent abdominal pain. Emerg Med 2006;38: 11-18.
• Bonnefoy S, Corberand D, Sinayoko L, et al. Epiploic appendagitis: report of a case. Gastroenterol Clin Biol. 2008;32(12):1092-1094.
• Vazquez-Frias JA, Castaneda P, Valencia S, Cueto J. Laparoscopic diagnosis and treatment of an acute epiploic appendagitis with torsion and necrosis causing an acute abdomen. JSLS. 2000;4:247-250.
• Rioux M, Langis P. Primary epiploic appendagitis: clinical, US, and CT findings in 14 cases. Radiology.1994;191:523-526.