KARIN AÐRILI OLGULARDA DÜZ KARIN GRAFÝSÝNÝN TANISAL DEÐERÝ

Akut karýn aðrýlý olgularda düz karýn grafisinin tanýsal deðerini, asistan ve radyolog ve genel cerrahi uzmaný deðerlendirmesi arasýndaki farký saptamak için prospektif bir çalýþma yapýlmýþtýr. Akut karýn aðrýsýyla Ýlk ve Acil Yardým anabilim dalýna baþvuran 88 olgu çalýþmaya alýndý. Tüm olgulara rutin olarak ayakta düz karýn grafisi çekildi. Ýlk aþamada olgu ve grafisi asistanlarca, daha sonra radyolog ve genel cerrahça deðerlendirildi. Grafiler 4 grupta incelendi, a) tanýya katkýsý yok, b) tanýya yardýmcý, c) taný koydurucu, d) yanlýþ taný. Klinik tanýlar 7 gruptaydý, a) akut apandisit (25 hasta) b) ileus (13 hasta) c) akut kolesistit (12 hasta) d) non-spesifik karýn aðrýsý (18 hasta) e) ürolitiazis (5 hasta) f) perforasyon (4 hasta) g) deðiþik tanýlar (11 hasta). Asistan deðerlendirmesinde grafilerin %73'ü tanýya katkýsý yok, %21 tanýya yardýmcý, %3,4 taný koydurucu olarak deðerlendirildi. Radyolog ve genel cerrahi deðerlendirmesinde ayný oranlar sýrasýyla % 75, %19, %6.8 olarak bulundu. Sonuçlarýmýz akut karýn aðrýlý olgularýn %75'inde direkt karýn grafisinin tanýya katkýsý olmadýðýný göstermektedir. Yanlýzca asistanlarýn deðerlendirilmesinde ise radyolog ve genel cerrahýn birlikte deðerlendirmesi kadar doðru oranlar bulunmuþtur.

THE DIAGNOSTIC VALUE OF PLAIN ABDOMINAL X-RAY IN ABDOMINAL PAIN

A prospective study was performed on patient with abdominal pain to evaluate of plain abdominal radiographs and to determine the differences of registrar and radiologist and general surgeon in diagnosis. Eighty eight patients with acute abdominal pain who admitted to department of emergency medicine were evaluated. The plain abdominal radiography were obtained in all of them. In first step, case and radiograph were evaluated by registrar and later, radiologist and surgeon assessment was done. Radiograph was classified by the authors into one of the following groups a) of no help in diagnosis b) diagnostic c) of help in diagnosis and d) wrong diagnosis. Seven acute abdominal conditions were considered a) acute appendicitis (25 patients) b) intestinal obstruction (13 patients) c) acute cholecystitis (18 patients) d) non-spesific abdominal pain (11 patients) e) urolithiazis (5 patients) f)perforation (4 patients) g) miscellaneous diagnosis (11 patients). In registrar evaluation radiograph were no help diagnosis in 73 percent of cases, help diagnosis in 21 percent of cases, helpful in 3.4 percent. This assessment had became respectively 75,19,68, percent in radiologist and surgeon evaluation. Our results suggest that for the 75 percent of all patients with acute abdominal pain there is little value in taking a plain abdominal radiograph. Registrar had assessment as right as radiologist and surgeon assessment.