Akutni epiploični apendagitis

master's thesis

• Title (english): Acute epiploic appendagitis
• Author: Karlo Crnković
• Mentor: Goran Augustin (mentor)
• Committee member: Hrvoje Silovski (predsjednik povjerenstva)
• Committee member: Tomislav Meštrović (član povjerenstva)
• Committee member: Goran Augustin (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Surgery); Zagreb
• Defense date and country: 2020-07-17, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Akutni epiploični apendagitis je rijetko potvrđen uzrok bolova u trbuhu. U većini slučajeva riječ je o samoograničavajućoj bolesti benignog tijeka. Riječ je o upali epiploičnog privjeska (lat. appendix epiploica) na kolonu. Bolest oponaša sliku akutnog abdomena, javlja se kao naglo nastali dobro lokaliziran oštar bol u abdomenu, najčešće u donjim kvadrantima. U većini slučajeva simptomi poput povišene tjelesne temperature, mučnine, povraćanja, proljeva, opstipacije, gubitka teka su blagi ili uopće nisu prisutni. Kliničkim pregledom moguće je uočiti znakove karakteristične za akutni apendicitis ili divertikulitis. Upalni parametri u većini slučajeva su unutar referentnih vrijednosti ili su blago povišeni. Češće obolijevaju ljudi sa povišenim BMI ili oni koji su naglo izgubili na tjelesnoj težini. Razlikujemo primarni i sekundarni oblik bolesti. Primarni epiploični apendagitis nastaje zbog infarkta epiploičnog privjeska koji je posljedica torzije samog privjeska ili tromboze odvodne vene. Sekundarni epiploični apendagitis nastaje zbog širenja upale iz okolnih struktura. Akutni epiploični apendagitis najuspješnije se dijagnosticira pomoću CT. Uspješno se liječi konzervativno davanjem nesteroidnih protuupalnih lijekova. Alternativna mogućnost liječenja je laparoskopija koju bi općenito trebalo izbjegavati i koristiti u slučaju recidivirajućih upala. Adekvatno dijagnosticiranje ove rijetke bolesti je važno kako bi se izbjegli nepotrebni operativni zahvati sa mogućim pratećim komplikacijama, ubrzao oporavak bolesnika te uštedjela financijska sredstva.

Abstract (english)

Acute epiploic appendagitis is rarely confirmed cause of abdominal pain. In most of cases it is a self - limiting disease with a benign course. It is an inflammation of the epiploic appendix (lat. appendix epiploica) of the colon. This disease mimics acute abdomen, starts as a sudden onset well-localized sharp pain of the abdomen, usually in the lower abdominal quadrants. In the majority of the cases, symptoms like high fever, nausea, vomiting, diarrhea, obstipation, loss of appetite are mild or not present. During clinical examination characteristic signs for acute appendicitis or diverticulitis can be positive. Inflammation parameters are within normal limits or slightly elevated in the majority of cases. Patients who have increased BMI or have recently lost weight are more susceptible to acute epiploic appendagitis. Epiploic appendagitis can be primary or secondary. Primary epiploic appendagitis is caused by infarction of the epiploic appendix as a result of the torsion of the appendix or due to thrombosis of a draining vein. Secondary epiploic appendagitis occurs due to an inflammatory process in a neighboring organ. The diagnostic modality of choice for the acute epiploic appendagitis is a CT scan. It is successfully treated conservatively with non - steroidal anti-inflammatory medications and intravenous fluids. An alternative option of treatment is a laparoscopy which should be avoided and used only in case of recurrent inflammation. Appropriate diagnosis of this rare disease is important in order to avoid unnecessary surgical intervention and its possible complications, speed up the recovery of the patient and save healthcare fundings.

• Keywords: akutni epiploični apendagitis; abdominalna kirurgija; CT; konzervativno liječenje
• Keywords (english): acute epiploic appendagitis; abdominal surgery; CT; conservative treatment
• Language: croatian
• URN:NBN: urn:nbn:hr:105:990690
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-05-12 10:49:09