Akut Apandisit
Özet
Akut apandisit, genel cerrahinin en sık karşılaşılan acillerinden biri olup, lümen obstrüksiyonu, intralüminal basınç artışı ve inflamasyon ile karakterizedir. Tanıda iştahsızlık, göbek çevresinde başlayıp sağ alt kadrana yerleşen tipik karın ağrısı, lökositoz ve ultrasonografi ile bilgisayarlı tomografi gibi radyolojik görüntüleme yöntemleri kritik rol oynar. Tedavide son yıllarda komplike olmamış vakalar için antibiyotik ile konservatif izlem alternatif bir yaklaşım olarak popülerlik kazansa da, apendektomi (açık, çok portlu laparoskopik veya tek insizyonlu laparoskopik cerrahi) halen altın standart tedavi yöntemi olmayı sürdürmektedir. Tanı ve klinik tablonun değişkenlik gösterebildiği gebe, yaşlı ve immunsuprese gibi özellikli hasta gruplarında gecikmeler perforasyon ve mortalite riskini ciddi oranda artırdığından, tanı algoritmalarının etkin kullanımı ve dikkatli klinik değerlendirme büyük önem taşımaktadır.
Acute appendicitis is one of the most common general surgical emergencies, characterized by luminal obstruction, increased intraluminal pressure, and inflammation. In diagnosis, anorexia, typical abdominal pain originating around the umbilicus and localizing to the right lower quadrant, leukocytosis, and radiological imaging methods such as ultrasonography and computed tomography play a critical role. Although conservative follow-up with antibiotics has gained popularity in recent years as an alternative approach for uncomplicated cases, appendectomy (open, multi-port laparoscopic, or single-incision laparoscopic surgery) still remains the gold standard treatment method. Since delays in special patient groups such as pregnant, elderly, and immunosuppressed individuals, where the diagnosis and clinical picture can vary, significantly increase the risk of perforation and mortality, the effective use of diagnostic algorithms and careful clinical evaluation are of great importance.
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