Öz
Akut apandisit hastalarında, sarılık ve yaygın karın ağrısı nadir görülen bulgulardır. Çoğunlukla geç dönemde başvuran komplike ve perfore/gangrenöz apandisit ile ilişkilendirilir. Sarılığa neden olan hiperbilirübineminin yaygın nedenleri; genetik hastalıklar, enfeksiyonlar, karaciğer ve safra kesesi hastalıkları, toksinler ve kalp yetmezliğidir. Karaciğer enzim seviyesinin normal olduğu hiperbilirubinemi ise sepsis, sistemik enfeksiyon, metabolik hastalıklar ve gebelikte görülebilir. Bilirübin düzeyi acil serviste ulaşımı ve değerlendirilmesi kolay bir laboratuvar parametresidir. Acil servise akut sarılık ile başvuran hastalarda izole hiperbilirubinemi tespit edildiğinde akut apandisit ön tanısı da akılda tutulmalıdır.
Anahtar Kelimeler
Kaynakça
- O’Mara SR, Gebreyes K. Hepatic disorders. In: Tintinalli JE, Stapczynski JS, Ma OJ, Yealy DM, Meckler GD, Cline DM (eds). A comprehensive Study Guide: Tintinalli’s Emergency Medicine. 8th ed. Mc Graw Hill; 2016:525.
- Eren T, Tombak E, Ozemir IA, et al. Hyperbilirubinemia as a predictive factor in acute appendicitis. Eur J Trauma Emerg Surg 2015;00068(15):562-4.
- Chaudhary P, Kumar A, Saxena N, Biswal UC. Hyperbilirubinemia as a predictor of gangrenous/perforated appendicitis: A prospective study. Ann Gastroenterol 2013;26(4):325-331.
- Sevinç MM, Kınacı E, Çakar E, et al. Diagnostic value of basic laboratory parameters for simple and perforated acute appendicitis: an analysis of 3392 cases. Ulusal Travma Acil Cerrahi Dergisi 2016;22(2):155-62.
- Estrada JJ, Petrosyan M, Barnhart J, et al. Hyperbilirubinemia in appendicitis: A New predictor of perforation. J Gastrointest Surg 2007;11(6):714-8.
- Giordano S, Paakkönen M, Salminen P, Grönroos JM. Elevated serum bilirubin in assessing the likelihood of perforation in acute appendicitis: A diagnostic meta-analysis. Int J Surg 2013;11(9):795-800.
- Khan S Kathmandu. Elevated serum bilirubin in acute appendicitis: A new diagnostic tool. Kathmandu Univ Med J 2008;6(2):161-5.
- Diagnostic Approach to the Adult with Jaundice or asymptomatic hyperbilirubinemia. [Updated Jan 29 2014; accessed Mar 2016]. Available from: URL: http://www.uptodate.com
Öz
Jaundice and diffuse abdominal pain are rare findings in patients with acute appendicitis and generally due to complicated late term of appendicitis such as perforated/gangrenous appendicitis. The common causes of hyperbilirubinemia which leads to jaundice are genetic disorders, infections, diseases of liver and gall bladder, toxins and heart failure. Hyperbilirubinemia with normal levels of liver enzymes could be the result of sepsis or systemic infections, metabolic disorders or pregnancy. Bilirubin levels could be easily detected in the emergency department. Acute appendicitis should be also kept in mind when isolated hyperbilirubinemia is detected in patients presenting with acute jaundice in the emergency department.
Anahtar Kelimeler
Kaynakça
- O’Mara SR, Gebreyes K. Hepatic disorders. In: Tintinalli JE, Stapczynski JS, Ma OJ, Yealy DM, Meckler GD, Cline DM (eds). A comprehensive Study Guide: Tintinalli’s Emergency Medicine. 8th ed. Mc Graw Hill; 2016:525.
- Eren T, Tombak E, Ozemir IA, et al. Hyperbilirubinemia as a predictive factor in acute appendicitis. Eur J Trauma Emerg Surg 2015;00068(15):562-4.
- Chaudhary P, Kumar A, Saxena N, Biswal UC. Hyperbilirubinemia as a predictor of gangrenous/perforated appendicitis: A prospective study. Ann Gastroenterol 2013;26(4):325-331.
- Sevinç MM, Kınacı E, Çakar E, et al. Diagnostic value of basic laboratory parameters for simple and perforated acute appendicitis: an analysis of 3392 cases. Ulusal Travma Acil Cerrahi Dergisi 2016;22(2):155-62.
- Estrada JJ, Petrosyan M, Barnhart J, et al. Hyperbilirubinemia in appendicitis: A New predictor of perforation. J Gastrointest Surg 2007;11(6):714-8.
- Giordano S, Paakkönen M, Salminen P, Grönroos JM. Elevated serum bilirubin in assessing the likelihood of perforation in acute appendicitis: A diagnostic meta-analysis. Int J Surg 2013;11(9):795-800.
- Khan S Kathmandu. Elevated serum bilirubin in acute appendicitis: A new diagnostic tool. Kathmandu Univ Med J 2008;6(2):161-5.
- Diagnostic Approach to the Adult with Jaundice or asymptomatic hyperbilirubinemia. [Updated Jan 29 2014; accessed Mar 2016]. Available from: URL: http://www.uptodate.com
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Olgu Sunumu |
| Yazarlar | |
| Yayımlanma Tarihi | 14 Mart 2019 |
| Gönderilme Tarihi | 23 Aralık 2017 |
| Yayımlandığı Sayı | Yıl 2019 |