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腹腔镜在儿童可疑腹痛中的作用。

The role of laparoscopy in suspicious abdomen pain in children.

机构信息

Dr. Zekeriya Ilce, Associate Professor, Department of Pediatric Surgery, Faculty of Medicine, Sakarya University, Sakarya, Turkey.

Dr. Turan Yildiz, Assistant Professor, Department of Pediatric Surgery, Faculty of Medicine, Sakarya University, Sakarya, Turkey.

出版信息

Pak J Med Sci. 2013 Jul;29(4):1042-5.

Abstract

OBJECTIVE

Abdominal pain is a frequently encountered problem in children. Suspicious right lower quadrant pains are sometimes a problem for pediatric surgeons. In this study, we wanted to evaluate the effectiveness of laparoscopy in diagnosis and treatment of children with suspicion of abdominal pain.

METHODS

The files of 84 patients treated with a diagnosis of suspicious right lower quadrant peritonitis between 2005 and 2011 were investigated. Laparoscopic exploration was performed for all cases with right lower quadrant pain where the appendix was not seen on USG/CT and the cause of acute abdomen could not be determined.

RESULTS

In this process, 84 patients consisting of 60 (71%) females and 24 (29%) males were included in the study. The mean age was 10.5 years (7-16 years). Appendicitis was determined during diagnostic laparoscopy in 35 (41.6%) patients. The appendix was normal in the remaining 49 (58.3%) patients. In 36 of these patients, gynecological diseases were encountered on pathology as the most frequent cause of the acute abdomen. The appendix was preserved in patients where the cause of the abdominal pain was explained.

CONCLUSION

Laparoscopy can be used in the diagnosis and treatment of patients with suspected acute abdomen that imitates acute appendicitis and cannot be differentiated with physical examination and laboratory methods. Delays in diagnosis and unnecessary appendectomy will be prevented in this way.

摘要

目的

腹痛是儿童中常见的问题。右下腹痛有时是小儿外科医生面临的问题。本研究旨在评估腹腔镜检查对疑似腹痛患儿的诊断和治疗效果。

方法

调查了 2005 年至 2011 年间因疑似右下象限腹膜炎而接受治疗的 84 名患者的档案。对所有右下腹痛但超声/CT 未见阑尾且无法确定急腹症病因的患者均进行腹腔镜探查。

结果

在这个过程中,研究纳入了 84 名患者,其中 60 名(71%)为女性,24 名(29%)为男性。平均年龄为 10.5 岁(7-16 岁)。诊断性腹腔镜检查发现 35 名(41.6%)患者为阑尾炎。其余 49 名(58.3%)患者阑尾正常。在这些患者中,有 36 名患者的妇科疾病是导致急性腹痛的最常见原因。对腹痛原因有明确解释的患者保留了阑尾。

结论

腹腔镜检查可用于诊断和治疗疑似急性阑尾炎且无法通过体格检查和实验室方法进行鉴别诊断的急性腹痛患者。这样可以避免诊断延迟和不必要的阑尾切除术。

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