Ulus Travma Acil Cerrahi Derg. 2010; 16(4): 327-333

Acil cerrahide ince baðýrsak tümörleri

Mustafa Turan¹, Kursat Karadayý¹, Mustafa Duman², Hatice Ozer³, Sema Arýcý³, Cihan Yýldýrýr⁴, Osman Koçak², Metin Sen^1
1Cumhuriyet Üniversitesi Týp Fakültesi Genel Cerrahi Anabilim Dalý, 58140, Sivas, Türkiye
²Kütahya Devlet Hastanesi Genel Cerrahi Servisi, Kütahya, 43170, Türkiye
³Cumhuriyet Üniversitesi Týp Fakültesi Patoloji Anabilim Dalý, 58140, Sivas, Türkiye
⁴Medical Park Hastanesi, Göztepe, Ýstanbul, Turkiye.

AMAÇ
Bu çalýþmanýn amacý, acil cerrahi sorunlarý ile hastanelerimize baþvuran ince baðýrsak tümörü olan 13 hastanýn klinik sürecini, taný çalýþmalarýný, uygulanan cerrahi iþlemleri ve saðkalýmlarýný irdelemektir.
GEREÇ VE YÖNTEM
1996 ile 2008 tarihleri arasýnda Cumhuriyet Üniversitesi Týp Fakültesi Genel Cerrahi Anabilim Dalý’nda ve Kütahya Devlet Hastanesi Genel Cerrahi Kliniði’nde ince baðýrsak tümörü nedeniyle acil cerrahi giriþim uygulanan 13 hastanýn dosyalarý retrospektif olarak deðerlendirildi.
BULGULAR
Hastalarýn yedisinde ince baðýrsak týkanýklýðý, beþinde perforasyon ve birinde de invajinasyon vardý. Histopatolojik olarak hastalarýn dördünde adenokarsinom, üçünde ince baðýrsak sarkomu, ikisinde Non-Hodgkin Lenfoma, birer hastada karsinoid tümör, ince baðýrsak anjiyoleiomiyomu, Brunner bezi adenomu ve ince baðýrsaðýn enflamatuvar psödotümörü saptandý. R0 rezeksiyon oraný %76 (10/13) iken R2 rezeksiyon üç (%23) hastada uygulanmýþtýr.
SONUÇ
Ýnce baðýrsak tümörleri çok nadir görülür. Bulgularý spesifik deðildir ve taný sürecinde daha ileri taný yöntemlerine gereksinim duyulmaktadýr. Bu tümörlerin biyolojik davranýþ tipi ve geliþim süreçlerine yapýlan giriþimin zamaný ve çeþidi saðkalýmý belirlemektedir.

Anahtar Kelimeler: Akut karýn, adenokarsinom; acil cerrahi; ince baðýrsak tümörü.

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Small bowel tumors in emergency surgery

Mustafa Turan¹, Kursat Karadayý¹, Mustafa Duman², Hatice Ozer³, Sema Arýcý³, Cihan Yýldýrýr⁴, Osman Koçak², Metin Sen^1
1Cumhuriyet University Faculty Of Medicine Department Of General Surgery, 58140, Sivas, Turkey
²Kutahya State Hospital, 43170, Kutahya, Turkey.
³Cumhuriyet University Faculty Of Medicine Department Of Pathology, 58140, Sivas, Turkey
⁴Medical Park Hospital, Goztepe, Istanbul, Turkey.

BACKGROUND
The aim of the present study was to describe the clinical presentation, diagnostic work-up, surgical therapy, and prognosis of 13 patients with small bowel tumor admitted for surgical procedures in an emergency setting.
METHODS
From 1996 to 2008, 13 consecutive surgical cases of small bowel tumors were treated at the Cumhuriyet University Faculty of Medicine, Department of General Surgery, and Kütahya State Hospital, Department of General Surgery. Clinical and radiological charts of these patients were reviewed retrospectively from the department database.
RESULTS
Intestinal obstruction (7 cases) and perforation (5 cases) were the most common clinical presentations, followed by intussusception (1 case). Adenocarcinoma was the most frequent histologic type (4 cases), while small bowel sarcoma was seen in three cases and non-Hodgkin lymphoma in two cases. The remaining cases had carcinoid tumor, small bowel angioleiomyoma, Brunner’s gland adenoma, and inflammatory pseudotumor of the small intestine.
CONCLUSION
Small bowel tumors are rare, the symptoms often non-specific, and the accuracy of different diagnostic tests remains to be improved. Timing and type of the intervention to the process and biological behavior of the pathological cells predict the prognosis.

Keywords: Acute abdomen, adenocarcinoma; emergency surgery; small bowel tumor.

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ATIF KOPYALA