Ulus Travma Acil Cerrahi Derg. 2009; 15(1): 77-81

Apandisit tanýsýnda Ohmann ve Eskelinen skorlarý ile lökosit sayýsý ve ultrasonografi bulgularýnýn deðerlendirilmesi

Gülten Kýyak, Birol Korukluoðlu, Yiðit Özgün, Ali Önder Devay, Ahmet Kuþdemir
Ankara Atatürk Eðitim Ve Araþtýrma Hastanesi, 2.Genel Cerrahi Kliniði, Ankara

AMAÇ: Bu çalýþmada, skorlama sistemlerinden Ohmann ve Eskelinen skorlarý, lökosit sayýsý ve ultrasonografinin (USG) akut apandisit tanýsýndaki yeri saptanmaya çalýþýldý. GEREÇ VE YÖNTEM: 01.05.2004-01.09.2005 tarihleri arasýnda akut apandisit ön tanýsý ile ameliyat edilen 186 hasta (105 erkek, 81 kadýn; ort. yaþ 29,94±12,70; daðýlým 6-70), geriye dönük olarak tarandý; Ohmann, Eskelinen skorlarý, lökosit sayýsý ve USG’nin tanýdaki önemi ve cinsiyetler arasýnda fark olup olmadýðý saptanmaya çalýþýldý. BULGULAR: Ohmann ve Eskelinen skorlarý deðerlendirildiðinde, genel hasta grubunda ve kadýn hastalarda apandisit olan ve olmayanlar arasýnda anlamlý fark saptandý (tüm gruplar için p=0,01); erkek hastalar için apandisit olan ve olmayanlar arasýnda fark saptanmadý (sýrasý ile p=0,341 ve p=0,217). Lökosit sayýsýnda artýþ ve USG deðerlendirilmesine bakýldýðýnda, kadýn hastalarda apandisit olan ve olmayanlar arasýnda lökosit sayýsýnda artýþ ve pozitif USG bulgusu arasýnda anlamlý fark saptandý (sýrasý ile p=0,001 ve p=0,001); erkek hastalarda anlamlý fark saptanmadý (sýrasý ile p=0,480 ve p=0,732). SONUÇ: Ohmann ve Eskelinen gibi skorlama sistemlerinin apandisit tanýsýnda veya tanýdan uzaklaþmak için kullanýlmasý, özellikle birinci basamak saðlýk hizmeti verilen ünitelerde kullanýlabilir. Apandisit tanýsýnýn güç olduðu özellikle üreme çaðýndaki kadýnlarda ise lökosit sayýsýndaki artýþýn tek baþýna belirleyici olabileceði ve USG’nin de ayýrýcý tanýda deðerli olduðu düþüncesindeyiz.

Anahtar Kelimeler: Apandisit/taný; duyarlýlýk ve özgüllük; lökosit; skor; ultrasonografi.

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Evaluation of Ohmann and Eskelinen scores, leukocyte count and ultrasonography findings for diagnosis of appendicitis

Gülten Kýyak, Birol Korukluoðlu, Yiðit Özgün, Ali Önder Devay, Ahmet Kuþdemir
Ankara Atatürk Research And Education Hospital, 2.General Surgery, Ankara

BACKGROUND: The purpose of this study was to demonstrate the diagnostic value of Ohmann and Eskelinen scores, leukocyte count and ultrasonographic (USG) evaluations in acute appendicitis. METHODS: This is a retrospective presentation of 186 patients (105 males, 81 females; mean age 29.94±12.70; range 6 to 70 years) operated with the diagnosis of acute appendicitis between May 1, 2004 and January 1, 2005. The diagnostic value of Ohmann and Eskelinen scores, leukocyte counts, and USG evaluations and the differences between the sexes were studied. RESULTS: According to the evaluation of Ohmann and Eskelinen scores, there were significant differences in positive and negative appendectomy between the total patient population and female patients (p=0.01), but no significant difference was found for men (p=0.341 and p=0.217, respectively). The leukocyte count increase and USG evaluations also demonstrated significant differences between negative and positive appendectomy in female patients (p=0.001 and p=0.001, respectively). However, no significant differences in the leukocyte count increase and USG evaluations between positive and negative appendectomy were determined in male patients (p=0.480 and p=0.732, respectively). CONCLUSION: Ohmann and Eskelinen scores could be useful in definitive diagnosis of appendicitis especially in primary care units. The leukocyte count increase alone or with the help of USG evaluation could be helpful in the diagnosis of appendicitis especially in females during the reproductive period.

Keywords: Appendicitis/diagnosis; sensitivity and specificity; leukocyte; score; ultrasonography.

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