Granülomatöz apandisitin basit laboratuar testleriyle ilişkisi. Kontrollü gözlemsel çalışma.

Abstract

Aim: Granulomatous appendicitis (GA) is evaluated as different clinical situation from specific causes, and very rare. It is defined as the presence of granulomatous inflammation in the appendix. Its etiology can be infectious, or noninfectious. However its differentiation from tumor can be challenging with macroscopic appearance in the operation. In this study, we aimed to present a case series of GA cases, evaluate prediction and association of GA before surgery. Material and Methods: A descriptive study is designed. All appendectomies between 2007 and 2015 were reviewed. The patients who diagnosed with GA by histopathological evaluation constituted study group. The rest constituted the control group. Demographic data, complete blood count parameters (22 parameters for each) were recorded. Categorical variables were expressed as frequencies and percentages. Baseline characteristics were compared using the t-test and Mann-Whitney U test. Fisher's exact test was used to compare categorical variables. The differences were considered statistically significant if the p value was less than 0.05 at a 95% confidence interval. Results: During study period, 4570 patients were operated for acute abdomen with the presumptive diagnosis of acute appendicitis. Eight (0.2%) patients constituted study group. For control group sample size was calculated as 527 cases (95% power to show a 50% difference in the rate of the primary outcome, with a 2-sided type I error rate of 5%. Additional 142 to decrease errors). Demographic findings like age and gender didn't show difference between the groups (p=0.499 and p=0.477, respectively). EOS# and EOS% were higher in study group than control group (p<0.0001 and p<0.0001, respectively). Logistic regression analysis showed that EOS% effect was significant with p of <0.0001, odds ratio of 0.522 and Nagelkerke R2 of 0.191. Conclusion: Diagnosis of GA with macroscopic appearance in operation is a challenging for a surgeon. We found that EOS# and EOS% are associated with GA. Keywords: Acute appendicitis, Granulomatous appendicitis, Prediction Öz Amaç: Granülomatöz apandisit (GA), spesifik nedenler ile oluşan farklı klinik durum olarak değerlendirilir ve çok nadirdir. Apendikste granülomatöz inflamasyon varlığı olarak tanımlanmaktadır. Etiyolojisi infeksiyöz veya infeksiyon dışı olabilir. Bununla birlikte, operasyondaki makroskopik görünümüyle tümörden ayırmak zor olabilir. Bu çalışmada, GA vaka serisi sunmayı ve cerrahiden önce GA öngörüsünü ve ilişkisini değerlendirmeyi amaçladık. Araç ve Yöntemler: Tanımlayıcı bir çalışma tasarlandı. 2007 ile 2015 yılları arasındaki tüm apendektomiler gözden geçirildi. Histopatolojik değerlendirme ile GA tanısı alan hastalar çalışma grubunu oluşturdu. Geriye kalanlar kontrol grubu oluşturdu. Demografik veriler, tam kan sayımı parametreleri (her biri için 22 parametre) kaydedildi. Kategorik değişkenler frekanslar ve yüzdeler şeklinde ifade edildi. Temel özellikler, t-testi ve Mann-Whitney U testi kullanılarak karşılaştırıldı. Kategorik değişkenleri ka...