Karaciğer Hastalıkları ve Karın Ağrısı

Mete Tuğcan  Üçdal

doi:10.37609/akya.4154

Yazarlar

Mete Tuğcan Üçdal

https://orcid.org/0000-0002-2321-2642

DOI: https://doi.org/10.37609/akya.4154.c8240

Özet

Karın ağrısı acil servis başvurularının en sık nedenlerinden biri olup karaciğer hastalıkları sağ üst kadran ağrısının önemli bir nedenidir. Akut karaciğer yetmezliği, portal hipertansiyon ve varis kanaması, karaciğer absesi, hepatoselüler karsinom rüptürü ve hepatik adenom gibi karaciğer patolojileri farklı mekanizmalarla karın ağrısına neden olabilmektedir. Glisson kapsülünün gerilmesi, karaciğer parankiminin inflamasyonu, vasküler konjesyon, iskemi ve kitle lezyonlarının rüptürü başlıca patofizyolojik mekanizmalardır. Bu bölümde acil serviste karaciğer hastalıklarına bağlı karın ağrısının epidemiyolojisi, klinik bulguları, tanısal yaklaşımları ve güncel kılavuzlar eşliğinde tedavi stratejileri ele alınmıştır. Akut karaciğer yetmezliğinde erken tanı ve transplantasyon değerlendirmesi, varis kanamasında kısıtlayıcı transfüzyon ve endoskopik tedavi, karaciğer absesinde antibiyoterapi ve perkütan drenaj, hepatoselüler karsinom rüptüründe hemodinamik stabilizasyon ve transkateter arteriyel embolizasyon tedavi yaklaşımlarının temel bileşenlerini oluşturmaktadır.

Abdominal pain is one of the most common reasons for emergency department visits, and liver diseases represent a significant cause of right upper quadrant pain. Hepatic pathologies including acute liver failure, portal hypertension and variceal bleeding, liver abscess, hepatocellular carcinoma rupture, and hepatic adenoma can cause abdominal pain through various mechanisms. Distension of Glisson’s capsule, hepatic parenchymal inflammation, vascular congestion, ischemia, and rupture of mass lesions are the main pathophysiological mechanisms. This chapter reviews the epidemiology, clinical features, diagnostic approaches, and current guideline-based treatment strategies for liver disease-related abdominal pain in the emergency department. Early diagnosis and transplantation evaluation in acute liver failure, restrictive transfusion and endoscopic therapy in variceal bleeding, antibiotherapy and percutaneous drainage in liver abscess, and hemodynamic stabilization with transcatheter arterial embolization in hepatocellular carcinoma rupture constitute the main components of the treatment approaches.

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