Ulus Travma Acil Cerrahi Derg. 2011; 17(6): 525-532 | DOI: 10.5505/tjtes.2011.65983

Abdominal aort anevrizmasýnda nadir görülen acil klinik durumlar: Basit kan testleri aciliyetin tanýmlanmasýnda yol gösterici midir?

Ali Fedakar¹, Orhan Fýndýk², Mehmet Kalender¹, Mehmet Balkanay^1
1Kartal Koþuyolu Yüksek Ýhtisas Hastanesi, Kalp Ve Damar Cerrahisi Kliniði Ýstanbul, Turkey
²Derince Eðitim Ve Araþtýrma Hastanesi,kalp Ve Damar Cerrahisi Kliniði,kocaeli, Turkey

AMAÇ
Bu çalýþmada, basit kan testlerinin acil abdominal aort anevrizmasýnýn (AAA) klinik sunumu ile iliþkisinin araþtýrýlmasý amaçlandý.
GEREÇ VE YÖNTEM
Ocak 1999 - Mart 2009 tarihleri arasýnda kliniðimiz acil servisine müracaat etmiþ ve hastaneye AAA tanýsý ile yatýrýlmýþ olan toplam 93 hasta geriye dönük olarak incelendi. Kronik sýnýrlandýrýlmýþ rüptür olgularý “Grup I”, rüptür tehdidi olgularý, “Grup II”, disekan rüptür olgularý “Grup III” ve gerçek (serbest) rüptür olgularý ise “Grup IV” olarak sýnýflandýrýldý.
BULGULAR
Kronik sýnýrlandýrýlmýþ rüptür hastalarýn 15’inde (%16,1), rüptür tehdidi 31’inde (%33), disekan rüptür 14’ünde (%15,1) ve gerçek (serbest) rüptür 27’sinde (%29) saptandý. Hastalarýn üçünde (%3,2) aortokaval fistül, ikisinde (%2,2) aortoenterik fistül, birinde (%1,1) aortobiliyer fistül tanýmlandý. Grup IV hemotokrit seviyesi, beyaz küre sayýsý, nötrofil ve lenfosit oranlarý, bikarbonat seviyesi ve mortalite oranlarý açýsýndan Grup I, II ve III’e göre istatiksel olarak anlamlý olan farklý parametrelere sahipti.
SONUÇ
Tanýda gecikmeyi önlemek için AAA’nýn acil kliniðinin deðiþkenlik gösterdiðinin bilinmesi önemlidir. Acil odasýnda alýnan basit kan testleri serbest rüptür açýsýndan oldukça yönlendirici olabilmektedir.

Anahtar Kelimeler: Abdominal aort anevrizmasý, acil; klinik bulgular.

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Unusual emergent presentations of abdominal aortic aneurysm: Can simple blood tests predict the state of emergency

Ali Fedakar¹, Orhan Fýndýk², Mehmet Kalender¹, Mehmet Balkanay^1
1Department Of Cardiac Surgery; Kartal Kosuyolu Education And Research Hospital, Ýstanbul, Turkey
²Department Of Cardiac Surgery; Derince Education And Research Hospital, Kocaeli, Turkey

BACKGROUND
This paper attempts to see if simple blood test results can predict the state of an emergency aneurysm as being non-ruptured, contained leak or free rupture.
METHODS
Ninety-three patients who presented to our emergency room and were operated for abdominal aortic aneurysm (AAA) between January 1999 and March 2009 were evaluated retrospectively. Cases were classified as: chronic contained rupture (Group I), impending rupture (Group II), dissecting rupture (Group III), and free rupture (Group IV).
RESULTS
Chronic contained rupture was determined in 15 (16.1%), impending rupture in 31 (33.3%), dissecting rupture in 14 (15.1%), and true (free) rupture in 27 (29%) cases. Aortocaval fistula was present in 3 (3.2%) patients, aortoenteric fistula in 2 (2.2%) and aorto biliary fistula in 1 (1.1%). Group IV was significantly different from Groups I, II and III with regard to hematocrit levels, white blood cell counts, neutrophils and lymphocyte rates, bicarbonate levels, and mortality rates.
CONCLUSION
To avoid a delay in diagnosis, it is important to know the different presentations of emergency AAA. In the emergency room, simple laboratory parameters may be highly directive in suspicion of ruptured AAA.

Keywords: Abdominal aortic aneurysm, emergency; clinical presentations.

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