Kaşifoğlu Timuçin, Cansu Döndü Usküdar, Korkmaz Cengiz
Division of Rheumatology, Deparment of Internal Medicine, Eskisehir Osmangazi University Medical Faculty, Eskişehir, Turkey.
Intern Med. 2009;48(7):523-6. doi: 10.2169/internalmedicine.48.1602. Epub 2009 Apr 1.
Familial Mediterranean fever (FMF) is characterized by recurrent episodes of peritonitis. Abdominal FMF attacks can be indistinguishable from those of an acute abdominal emergency, and patients may undergo one or more laparotomies before the true nature of their disease is documented. The objectives of this study were to investigate the frequency and reasons for abdominal surgeries performed on patients with FMF.
We retrospectively reviewed the files of 254 patients with FMF (127 males, 127 females, mean age 27.2+/-6.3 years). We also included 182 healthy individuals for this study (89 males, 93 females, mean age 27.6+/-5 years; range 11-43) to make a comparison between FMF and healthy controls (HC) with respect to frequency of abdominal operations.
The number of patients with abdominal surgery in FMF group was 74 (29.1%). The number of surgeries performed in 74 patients with FMF was 92. The first abdominal surgery before the diagnosis of FMF was appendectomy in 68 patients (26.6%). In HC group, the number of abdominal operations was found to be 16 (8.7%). Of these abdominal operations, 9 (4.9%) were due to appendectomy. The rate of total abdominal operations and appendectomy were significantly higher in FMF group than in HC group (p=0.0001).
Abdominal attacks of FMF patients may cause an unnecessary laparotomy prior to the diagnosis of FMF. FMF patients can present with abdominal emergency while they are receiving colchicine. Therefore, each abdominal pain should be carefully determined according to clinical findings. The purpose of this study was to emphasize the misdiagnosis of appendicitis.
家族性地中海热（FMF）的特征是反复出现腹膜炎发作。腹部FMF发作可能与急性腹部急症难以区分，患者在疾病的真正性质被确诊之前可能会接受一次或多次剖腹手术。本研究的目的是调查FMF患者进行腹部手术的频率及原因。
我们回顾性分析了254例FMF患者（127例男性，127例女性，平均年龄27.2±6.3岁）的病历。我们还纳入了182名健康个体参与本研究（89例男性，93例女性，平均年龄27.6±5岁；年龄范围11 - 43岁），以便在腹部手术频率方面对FMF患者和健康对照（HC）进行比较。
FMF组中有腹部手术史的患者为74例（29.1%）。74例FMF患者共进行了92次手术。在FMF确诊前首次进行的腹部手术中，68例（26.6%）为阑尾切除术。在HC组中，发现腹部手术例数为16例（8.7%）。在这些腹部手术中，9例（4.9%）是阑尾切除术。FMF组的腹部手术总数和阑尾切除术发生率均显著高于HC组（p = 0.0001）。
FMF患者的腹部发作可能导致在FMF确诊前进行不必要的剖腹手术。FMF患者在接受秋水仙碱治疗时可能会出现腹部急症。因此，应根据临床检查结果仔细判断每一例腹痛情况。本研究的目的是强调阑尾炎的误诊情况。
