Publication: Cerrahi kliniklerinde tedavi edilen barsak tıkanması olgularının retrospektif değerlendirilmesi
Abstract
Bu çalışmada, 1995-1998 yılları arasında Haydarpaşa Numune Eğitim ve Araştırma Hastanesi'nde cerrahi kliniklerinde barsak tıkanıklığı tanısı almış, 9-100 yaş arası, 117 erkek ve 48 kadın olmak üzere toplam 165 hasta retrospektif değerlendirildi. Barsak tıkanması olgularında, yaş ve cinsiyete göre dağılımın, etyolojik faktörlerin, sık gözlenen başvuru semptomlarının ve fizik muayene bulgularının belirlenmesi amaçlandı. Hastalarda, özgeçmiş bulguları, semptomlar ve semptom-başvuru süresi ile hastanede yatış süresi, fizik muayene bulguları, kesin tanı, biyokimyasal parametreler, uygulanan tedavi ve prognoz ayrıntılı olarak arşiv kayıtlarından incelendi. Barsak tıkanması nedenleri arasında, geçirilmiş cer¬rahi operasyonlara bağlı adezyonlar ilk sırada gözlendi. Apandektomilerin en sık yapılan operasyon olması nedeniyle, apandektomi sonrası adezyon oluşumu, en sık görülen neden olarak belirlendi. Gelişmiş ülkelerde ön sıralarda yer alan malignite sonucu ortaya çıkan barsak tıkanmalarına ve volvulus nedenli barsak tıkanmalarına çalışmamızda daha az sıklıkta rastlandı. Bu durum, Türkiye'de ortalama yaşam süresinin gelişmiş ülkelerden kısa olması ve diyet alışkanlığının farklı olması ile açıklanabilir. Sonuç olarak, birinci basamakta, hekimin barsak tıkanıklığı ile başvuran hastayı değerlendirmesi ve acil cerrahi birimle işbirliği, erken müdahale olanağı sağlayarak komplikasyonların azaltılmasında büyük önem taşımaktadır.
In this study, a total of 165 patients (117 men and 48 women) aged between 9 and 100 years diagnosed as intestinal obstruction in Haydarpaşa Numune Education and Investigation Hospital between 1995 and 1998, were evaluated retrospectively. It was aimed to determine the age and sex distribu¬tion, etiologic factors, referral symptoms and physical examination findings encountered frequently for the intestinal obstruction cases. Detailed history, symptoms, referral time to the hospital, hospitalisation time, physical examination findings, diagnosis, biochemical parameters, treatment applied and prognosis were evaluated in detail from the archives records. Adhesions depending upon surgical procedures were in the first place for the intestinal obstruction cases. As appendectomies are frequently performed operations, adhesion formations afterwards were determined as the most frequent cause. Intestinal obstructions due to malignity or volvulus, which are frequently encountered in developed countries, were encountered less frequently in our study. This can be explained by the fact that Turkish mean survival expectancy is shorter than developed countries and dietary habits are different. In conclusion, thorough physical examination of the patient referred for ileus and participation of the family medicine specialist in the emergency care unit with general surgery department will decrease the compli¬cations by providing early intervention.
In this study, a total of 165 patients (117 men and 48 women) aged between 9 and 100 years diagnosed as intestinal obstruction in Haydarpaşa Numune Education and Investigation Hospital between 1995 and 1998, were evaluated retrospectively. It was aimed to determine the age and sex distribu¬tion, etiologic factors, referral symptoms and physical examination findings encountered frequently for the intestinal obstruction cases. Detailed history, symptoms, referral time to the hospital, hospitalisation time, physical examination findings, diagnosis, biochemical parameters, treatment applied and prognosis were evaluated in detail from the archives records. Adhesions depending upon surgical procedures were in the first place for the intestinal obstruction cases. As appendectomies are frequently performed operations, adhesion formations afterwards were determined as the most frequent cause. Intestinal obstructions due to malignity or volvulus, which are frequently encountered in developed countries, were encountered less frequently in our study. This can be explained by the fact that Turkish mean survival expectancy is shorter than developed countries and dietary habits are different. In conclusion, thorough physical examination of the patient referred for ileus and participation of the family medicine specialist in the emergency care unit with general surgery department will decrease the compli¬cations by providing early intervention.