Spot İdrarda Bakılan 5-Hi̇droksi̇ İndol Aseti̇k Asi̇ti̇n Akut Apandi̇si̇t Tanısında Değeri (The Value of Acute Appendicitis Viewed 5-Hydroxy Indole Acetic Acid in Spot Urine)

Abstract

Amac: Bu calisma, akut apandisit suphesi nedeniyle acile basvuran hastalarda, idrarda bakilan 5-Hidroksi Indol Asetik Asit seviyesinin tani koymada anlamliligini degerlendirmektedir. Yontem: 2011 Ocak- 2011 Aralik aylari arasinda klinigimize karin agrisi nedeniyle basvuran hastalarda idrarda 5-Hidroksi Indol Asetik Asit ileriye donuk olarak calisma yapilmistir. Sonuclar: Bir yillik surede klinigimize karin agrisi nedeniyle basvuran ve interne edilen, ortalama yaslari 10.4 yil ±3.4 olan toplam 49 hastanin klinik degerlendirme sonrasi, 32 hastada apandisit, 17 hastada apandisit harici karin agrisi tespit edilmistir. Appendektomi yapilan 2 hastada apendiks normal olarak degerlendirilmistir. Tum basvuran hastalardan ilk basvuruda idrar ornekleri alinmistir. Her 2 grup karsilastirildiginda spot idrar 5-Hidroksi Indol Asetik Asit duzeyleri arasindaki fark istatistiksel olarak anlamli bulunmamistir (p>0.05). Spot idrar 5-Hidroksi Indol Asetik Asit duzeylerinde ozgulluk, duyarlilik, pozitif ongoru degeri, negatif ongoru degeri sirasiyla %63, %66, %54 ve %73 olarak bulunmustur. Sonuc: Spot idrar 5-Hidroksi Indol Asetik Asit degeri cocuklarda akut apandisit tanisinda tek tip parametre olarak kullanildiginda sinirli tanisal degeri oldugu saptanmistir. Anahtar Kelimeler: Akut Apandisit, Akut Karin, 5 Indol Asetik Asit, Somatostatin, Cocuk ABSTRACT Backgraund/Aim: This study is to investigate the significance of spot urine 5-hydroxy indol acetic acid levels in patients admitted with the suspicion of acute apendicitis. Material/Method: Between January 2011 and June 2011, patients with the complaints of abdominal pain were evaluated according to levels of 5-hydroxy indol acetic acid in urine at admission. This study was designed as prospectively. Results: Forthy-nine patients with the mean age of 10.4 years ±3.4 who were admitted and interned to our department during the one year period with the complaints of abdominal pain. After the clinical evaluation appendicitis was detected in 32 patients and abdominal pain was found to be due to causes other than appendicitis in 17 patients. Two of the patiens were negatif appendectomy. Spot urine samples were collected in all patients during admission and 5-hydroxy indol acetic acid levels were studied. The differences between the patients with acute appendicitis and other groups were not statistically significant (p>0.05). Sensitivity, specifity, positive predictive value and diagnostic specificity of 5-hydroxy indol acetic acid level in spot urine were 63%, 66%, 54%, 73%, respectively. Conclusion; Spot urine 5-hydroxy indol acetic acid levels in diagnosis of acute appendicitis seems to have limited diagnostic power as a single parameter in children. Key Words: Acut Appendicitis, Acut abdomen, 5-hydroxy indole acetic acid, Somatositatin, Child