Araştırma Makalesi
BibTex RIS Kaynak Göster

Evaluation of patients with ascites in the Şanlıurfa Region

Yıl 2019, Cilt: 18 Sayı: 1, 23 - 26, 29.04.2019
https://doi.org/10.17941/agd.544712

Öz

Background and Aims: This study aimed to evaluate patients with ascites who were followed to investigate their demographic, clinical, laboratory, and etiological features. Materials and Methods: The study was conducted from January 2013 to October 2014, and included patients with ascites that was detected for the first time before or diagnosed during this period. Patients with sufficient data in their files were included. Results: Examinations were conducted by the gastroenterology clinic because of ascites. This study included 142 patients, 65 (46%) were male and had a mean age of 58.4±16 years (range, 16-89 years). Also, 114 patients (80%) had portal ascites, whereas 28 (20%) had non-portal ascites. All-cause ascites (68%) and portal-type ascites (85%) were the most common causes of liver cirrhosis. Three cirrhotic patients had hepatocellular carcinoma and B cell lymphoma was detected in 1 patient. Other causes of portal ascites were cardiogenic in 4 patients, chronic kidney failure in 4 patients, Budd-Chiari in 3 patients, short bowel syndrome due to hypoalbuminemia in 2 patients, portal vein thrombosis in 1 patient, hypothyroidism in 1 patient. Causes of non-portal type ascites were in peritoneal carcinomatosis 10 patients (7%), ovarian cancer in 6 patients (4%), peritoneal tuberculosis in 5 patients (3%), gastric cancer in 2 patients, one in a patient with periampullary cancer, cyst rupture, endometrial cancer, nephrotic syndrome and postoperative biliary leakage was ascites. Conclusion: Approximately 80% of patients with ascites have portal hypertensive-type ascites. It is the most common cause of both cirrhosis and portal hypertension. Non-portal ascites is the most common malignancy and occurs in about two-thirds of patients, whereas the second reason is peritoneal tuberculosis.


Kaynakça

  • 1. Serin E, Boyacıoğlu S. Siroz komplikasyonları ve tedavisi. In: Gastroenteroloji. Özden A, Şahin B, Yılmaz U, Soykan İ. (Eds) 1. Baskı. Fersa Matbaacılık, 2002: 528-532.
  • 2. Ökten A, Mungan Z, Cakaloğlu Y, Boztaş G, Kaymakoğlu S, Beşışık F, Özdil S. Gastroenterohepatoloji. Nobel Tıp Kitapevleri, 2001: 345-368.
  • 3. Kuiper JJ, van Buuren HR, de Man RA. Ascites in cirrhosis: a review of management and complications. Neth J Med 2007; 65: 283-8.
  • 4. Biecker E. Diagnosis and therapy of ascites in liver cirrhosis. World J Gastroenterol 2011;17:1237-48.
  • 5. Knudsen AW, Krag A, Nordgaard-Lassen I, et al. Effect of paracentesis on metabolic activity in patients with advanced cirrhosis and ascites. Scand J Gastroenterol 2016;51:601-9.
  • 6. Gaetano JN, Micic D, Aronsohn A, et al. The benefit of paracentesis on hospitalized adults with cirrhosis and ascites. J Gastroenterol Hepatol 2016;31:1025-30.
  • 7. Özdemir S. Cirrhotic ascites. Medical Journal of Bakırköy 2013;9:1-7.
  • 8. Gines P, Quintero E, Arroyo V, et al. Compensated cirrhosis: natural history and prognostic factors. Hepatology 1987;7:122-8.
  • 9. Kashani A, Landaverde C, Medici V, Rossaro L. Fluid retention in cirrhosis: pathophysiology and management. QJM 2008;101:71-85.
  • 10. Hoefs JC. Serum protein concentration and portal pressure determine the ascitic fluid protein concentration in patients with chronic liver disease. J Lab Clin Med 1983;102:260-73.
  • 11. Pare P, Talbot J, Hoefs JC. Serum ascites albumin concentration gradient: a physiologic approach to the differantial diagnosis of ascites. Gastroenterology 1983; 85: 240-244.
  • 12. Hoefs JC. Diagnostic paracentesis: a potent clinical tool (editorial). Gastroenterology 1990;98:230-6.
  • 13. Sola E, Sole C, Gines P. Management of uninfected and infected ascites in cirrhosis. Liver Int 2016;36(Suppl 1):109-15.
  • 14. Meral CE, Karaali ZE, Yanmaz S, et al. Etiological distribution of ascites investigated patients. Med Bull Haseki 2005;43:0-0.
  • 15. Çakaloğlu Y, Ökten A, Yaçın S. Serum ascites albümin concentration gradient (A-GRAD) in the prediction of of portal hypertension in ascitic patients. Gastroenterology 1991:100;1484-5.
  • 16. Runyon BA, Practice Guidelines Committee, American Association for the Study of Liver Diseases (AASLD). Management of adult patients with ascites due to cirrhosis. Hepatology 2004;39:841-56.
  • 17. Al-Knawy BA. Etiology of ascites and the diagnostic value of serum-ascites albumin gradient in non-alcohol liver disease. Ann Saudi Med 1997;17:26-8.
  • 18. Akriviadis EA, Kapnias D, Hadjigavriel M, et al. Serum/ascites albumin gradient: its value as a rational approach to the differential diagnosis of ascites. Scand J Gastroenterol 1996;31:814-7.
  • 19. Uyanıkoğlu A, Aydın F, Altunbaş R, et al. Siroz etiyolojisinde NASH’in yeri nedir? 12. Ulusal Hepato-Gastroenteroloji Kongre Kitabı. 8-10 Ekim 2015, Afyon, SB-10, 82.

Şanlıurfa Yöresi Asitli Hastaların Değerlendirilmesi

Yıl 2019, Cilt: 18 Sayı: 1, 23 - 26, 29.04.2019
https://doi.org/10.17941/agd.544712

Öz

Giriş ve Amaç: Asit tetkik nedeniyle takip edilen hastaların
demografik, klinik, laboratuvar ve etiyolojik özelliklerinin araştırılması
amaçlanmıştır. 
Gereç ve Yöntem: Araştırmaya Ocak 2013- Ekim 2014 döneminde ilk defa asit
tespit edilen veya daha önce tanı konulan, dosyalarında yeterli veri bulunan
hastalar dahil edilmiştir. 
Bulgular: Gastroenteroloji kliniğine asit tetkik nedeni ile yatırılan veya
takip edilen 142 hastanın
65’i (%46) erkek, yaş ortalaması 58.4±16 yaş
(dağılım 16-89) idi. Hastaların 114’ünde (%80) portal asit, 28’inde (%20) non portal
asit saptandı. Tüm asit nedenlerinde (%68) ve portal tip asitte (%85) en sık
neden karaciğer sirozu idi. Sirotik hastalardan 3 tanesinde hepatosellüler
kanser, 1 tanesinde B hücreli lenfoma saptandı.
 Diğer portal tip asit nedenleri; 4
kardiyojenik, 4 kronik böbrek yetmezliği, 3 hasta Budd-Chiari, 2 kısa barsak
sendromuna bağlı hipoalbüminemi, 1 portal tromboz, 1 hipotroidi, olarak
saptandı. Non portal tip asit nedenleri ise 10 hastada (%7) primeri belli
olmayan peritoneal karsinomatoz, 6 (%4) over kanseri, 5 (%3) tüberküloz
peritonit, 2 mide kanseri, birer hastada periampüller kanser, kist hidatik
rüptürü, endometrium kanseri, nefrotik sendrom ve ameliyat sonrası safra kaçağına
bağlı asit idi.
 Sonuç:
Asitli hastaların yaklaşık %80’i portal hipertansif tip asit olup tüm asit
nedenleri ve portal hipertansif asitte en sık neden siroz olarak bulundu. Non portal
asitte en sık neden malignite olup hastaların yaklaşık üçte ikisinden sorumlu,
ikinci en sık neden ise tüberküloz peritonit idi.  


Kaynakça

  • 1. Serin E, Boyacıoğlu S. Siroz komplikasyonları ve tedavisi. In: Gastroenteroloji. Özden A, Şahin B, Yılmaz U, Soykan İ. (Eds) 1. Baskı. Fersa Matbaacılık, 2002: 528-532.
  • 2. Ökten A, Mungan Z, Cakaloğlu Y, Boztaş G, Kaymakoğlu S, Beşışık F, Özdil S. Gastroenterohepatoloji. Nobel Tıp Kitapevleri, 2001: 345-368.
  • 3. Kuiper JJ, van Buuren HR, de Man RA. Ascites in cirrhosis: a review of management and complications. Neth J Med 2007; 65: 283-8.
  • 4. Biecker E. Diagnosis and therapy of ascites in liver cirrhosis. World J Gastroenterol 2011;17:1237-48.
  • 5. Knudsen AW, Krag A, Nordgaard-Lassen I, et al. Effect of paracentesis on metabolic activity in patients with advanced cirrhosis and ascites. Scand J Gastroenterol 2016;51:601-9.
  • 6. Gaetano JN, Micic D, Aronsohn A, et al. The benefit of paracentesis on hospitalized adults with cirrhosis and ascites. J Gastroenterol Hepatol 2016;31:1025-30.
  • 7. Özdemir S. Cirrhotic ascites. Medical Journal of Bakırköy 2013;9:1-7.
  • 8. Gines P, Quintero E, Arroyo V, et al. Compensated cirrhosis: natural history and prognostic factors. Hepatology 1987;7:122-8.
  • 9. Kashani A, Landaverde C, Medici V, Rossaro L. Fluid retention in cirrhosis: pathophysiology and management. QJM 2008;101:71-85.
  • 10. Hoefs JC. Serum protein concentration and portal pressure determine the ascitic fluid protein concentration in patients with chronic liver disease. J Lab Clin Med 1983;102:260-73.
  • 11. Pare P, Talbot J, Hoefs JC. Serum ascites albumin concentration gradient: a physiologic approach to the differantial diagnosis of ascites. Gastroenterology 1983; 85: 240-244.
  • 12. Hoefs JC. Diagnostic paracentesis: a potent clinical tool (editorial). Gastroenterology 1990;98:230-6.
  • 13. Sola E, Sole C, Gines P. Management of uninfected and infected ascites in cirrhosis. Liver Int 2016;36(Suppl 1):109-15.
  • 14. Meral CE, Karaali ZE, Yanmaz S, et al. Etiological distribution of ascites investigated patients. Med Bull Haseki 2005;43:0-0.
  • 15. Çakaloğlu Y, Ökten A, Yaçın S. Serum ascites albümin concentration gradient (A-GRAD) in the prediction of of portal hypertension in ascitic patients. Gastroenterology 1991:100;1484-5.
  • 16. Runyon BA, Practice Guidelines Committee, American Association for the Study of Liver Diseases (AASLD). Management of adult patients with ascites due to cirrhosis. Hepatology 2004;39:841-56.
  • 17. Al-Knawy BA. Etiology of ascites and the diagnostic value of serum-ascites albumin gradient in non-alcohol liver disease. Ann Saudi Med 1997;17:26-8.
  • 18. Akriviadis EA, Kapnias D, Hadjigavriel M, et al. Serum/ascites albumin gradient: its value as a rational approach to the differential diagnosis of ascites. Scand J Gastroenterol 1996;31:814-7.
  • 19. Uyanıkoğlu A, Aydın F, Altunbaş R, et al. Siroz etiyolojisinde NASH’in yeri nedir? 12. Ulusal Hepato-Gastroenteroloji Kongre Kitabı. 8-10 Ekim 2015, Afyon, SB-10, 82.
Toplam 19 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Makaleler
Yazarlar

Ahmet Uyanıkoğlu 0000-0003-4881-5244

Hüseyin Dursun Bu kişi benim

Çiğdem Cindoğlu Bu kişi benim

Hacer Uyanıkoğlu Bu kişi benim

Necati Yenice Bu kişi benim

Yayımlanma Tarihi 29 Nisan 2019
Yayımlandığı Sayı Yıl 2019 Cilt: 18 Sayı: 1

Kaynak Göster

APA Uyanıkoğlu, A., Dursun, H., Cindoğlu, Ç., Uyanıkoğlu, H., vd. (2019). Şanlıurfa Yöresi Asitli Hastaların Değerlendirilmesi. Akademik Gastroenteroloji Dergisi, 18(1), 23-26. https://doi.org/10.17941/agd.544712

test-5