ÇOCUKTA NADİR BİR AKUT KARIN SEBEBİ: ENDOMETRİOTİK KİST*

Endometriozis, endometrium dokusunun normal lokalizasyonunun disinda bir lokalizasyonda bulunmasidir. Kronik pelvik agri hikayesi olan adole- sanlarin %25-38’ inde endometriozis tespit edilmistir. Bu calisma ile, co- cukta nadir akut karin sebebi olarak saptanan bir endometriotik kist olgusu- nu sunmak istedik. On bes yasindaki hasta, sol alt kadran agrisi ve kusma sikayetleri ile klinigimize basvurdugunda fizik muayenesinde akut karin bulgulari vardi. Pelvik ultrasonografisinde sol over torsiyonu ve subseroz myom izlenen hasta operasyona alindi. Eksplorasyonda overlerde sadece follikul kistleri mevcutken, uterus kubbesinde, uzerinde kanama odagi iz- lenen nekrotik gorunumlu subseroz myomla uyumlu lezyon izlendi. Kitle eksize edildi. Patolojik incelemede bu lezyon endometriotik kist olarak tani aldi. Adolesanlarda akut karinin nadir sebeplerinden biri olan endometriotik kistlerin ameliyat oncesinde, hatta ameliyat sirasinda dahi tanisi guctur. Anahtar Kelimeler: Endometriotik kist, akut karin, cocuk. A RARE CAUSE OF ACUTE ABDOMEN IN CHILDREN: ENDO- METRIOTIC CYST Endometriosis is characterized by the presence of endometrial tissue outside the normal location. In adolescents with a history of chronic pelvic pain, stu- dies have reported a 25-38% incidence of endometriosis. We present a case of an endometriotic cyst that was the cause of acute abdomen. A 15-year old girl was admitted with left lower quadrant abdominal pain and vomiting. During the examination there were acute abdomen findings and ultrasonog- raphy diagnosed a left ovarian torsion and subserosal myoma uteri. During the operation, there was hemorrhagic fluid in the abdomen, the left ovary had no torsion but both of the ovaries had follicle cysts, and on the upper side of the corpus uteri there was a hemorrhagic subserous myoma that had hemorrhage and necrosis. The lesion on the corpus uteri was excised comp- letely. The pathological diagnosis of the lesion revealed an endometriotic cyst. The accurate diagnosis of endometriotic cysts before or during surgery is difficult because of its rarity. Key Words: Endometriotic cyst, acute abdomen, child.