Apendiks mukoselini akut apandisitten ayırmada klinik, radyolojik ve laboratuvar belirteçlerin rolü

Hacı Bolat, Ali Erdoğan, Caner Özbey
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Abstract

ABSTRACT AIM: This study aims to assist the surgical treatment plan by increasing the rate of correct preoperative diagnoses through comparing the clinical, radiological, and laboratory findings of appendiceal mucocele (AM) and acute appendicitis (AA) before surgery. MATERIALS AND METHODS: The study included 63 patients with a histopathologic diagnosis of AM and AA among 4867 patients who underwent appendectomy with the diagnosis of acute appendicitis in the general surgery clinic between 2009 and 2020. The patients were separated into two groups: those with AM (21 patients) and those with AA (42 patients). Age, gender, physical examination (PE), Alvarado appendicitis score, ultrasonography (USG), computed tomography (CT), laboratory, preoperative diagnosis, intraoperative diagnosis, and pathological diagnosis results of both groups were compared. RESULTS: PE, abdominal pain, nausea, vomiting, fever symptoms, and Alvarado score were found to be significant between the two groups (p<0.05). In addition, WBC, NE, LYM %, and CRP were found to be high in group 2 (p<0.05), while there was no difference in radiological diagnosis (USG/CT) between the two groups (p<0.05). However, the appendix diameter was larger in group 1 (p<0.05). Patients with AM in 80% preoperatively, and 52% intraoperatively were operated on with a provisional diagnosis of AA. The second surgery was performed in Group 1 with a rate of 9.5% (2/21). CONCLUSION: In our study, patients with AM who underwent surgery with a diagnosis of AA were found to differ in radiological, clinical, and laboratory findings from patients with AA. KEYWORDS: Appendiceal Mucocele, Acute Appendicitis, Differential Diagnosis
临床、放射学和实验室指标在区分阑尾粘液瘤和急性阑尾炎中的作用
ABSTRACTAIM: 本研究旨在通过比较阑尾粘液瘤(AM)和急性阑尾炎(AA)术前的临床、放射学和实验室检查结果,提高术前诊断的正确率,从而帮助制定手术治疗方案。这些患者被分为两组:AM 患者(21 人)和 AA 患者(42 人)。比较两组患者的年龄、性别、体格检查(PE)、阿尔瓦拉多阑尾炎评分、超声波检查(USG)、计算机断层扫描(CT)、实验室检查、术前诊断、术中诊断和病理诊断结果。结果:发现两组患者的 PE、腹痛、恶心、呕吐、发热症状和 Alvarado 评分差异显著(P<0.05)。此外,发现第 2 组的白细胞、NE、LYM % 和 CRP 偏高(P<0.05),而两组的放射诊断(USG/CT)无差异(P<0.05)。然而,第 1 组的阑尾直径更大(P<0.05)。80% 的 AM 患者术前诊断为 AA,52% 的患者术中临时诊断为 AA。第 1 组进行第二次手术的比例为 9.5%(2/21)。结论:在我们的研究中发现,在诊断为 AA 的情况下接受手术的 AM 患者与 AA 患者在放射学、临床和实验室检查结果上存在差异。关键词: 阑尾黏液囊 急性阑尾炎 鉴别诊断
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