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Pulmoner Emboli Tans Hala Bir kilem mi? Hangi Skorlama Sistemi Bizi Tanya Gtrr?: Olgu Sunumu [Respir Case Rep]
Respir Case Rep. 2019; 8(1): 17-20 | DOI: 10.5505/respircase.2019.35762

Pulmoner Emboli Tans Hala Bir kilem mi? Hangi Skorlama Sistemi Bizi Tanya Gtrr?: Olgu Sunumu

Alten Oskay, Cihangir elik, Kvan Karaman, Hamit Hakan Armaan, nder Tomruk
Sleyman Demirel niversitesi Tp Fakltesi, Acil Tp Ana Bilim Dal, Isparta, Trkiye

Pulmoner emboli (PE) tansn kolaylatrmak, hastalarn acil servisten gvenle taburculuunu salayabilmek, hastalar iyonizan radyasyon ve opak maddelerin komplikasyonlarndan koruyabilmek iin eitli skorlama sistemleri kullanlmaktadr. Altm alt yanda aktif erkek hasta acil servise geirmi olduu senkop nedeniyle getirildi. Hasta batc tarzdaki gs arsndan, hemoptizi ve hafif bir retrosternal sknt hissinden ikayetiydi. Vital bulgularnda hipoksemisi (SpO2=88%) mevcuttu. D-dimer deeri 165ng/mL (normal snrlar: 69-243) olarak saptand. PE olasl 2 kategorili Wellste dk, D-dimer negatiflii ile birlikte deerlendirilen rGeneva skorlama sistemlerinde %2 olarak ngrlmesine ve YEARS skalasnda tamamen dlanmasna ramen hastaya pulmoner bilgisayarl tomografi anjiografi ekildi. Her iki ana pulmoner arterde pulmoner emboli saptand. Sklkla kullanlan skorlama sistemlerinin tedavi gerektiren PEyi tanmakta yetersiz kalabildikleri grlmektedir. Klinik algnn stn olduu baz noktalar hala vardr.

Anahtar Kelimeler: Acil servis, D-dimer, Klinik olaslk, Klinik skorlama sistemleri, Pulmoner emboli

Is the Diagnosis of Pulmonary Embolism Using Scoring Systems Still a Dilemma?: A Case Report

Alten Oskay, Cihangir elik, Kvan Karaman, Hamit Hakan Armaan, nder Tomruk
Department of Emergency Medicine, Sleyman Demirel University, Isparta, Turkey

Various scoring systems are used to facilitate the diagnosis of pulmonary embolism (PE), provide for the safe discharge of patients from emergency departments (EDs), and protect patients from complications caused by ionizing radiation and iodinated contrast media. A 66-year-old active male patient was brought to the ED due to syncope. He complained of a stinging type of chest pain, hemoptysis, and a mild feeling of retrosternal distress. He had hypoxemia (SpO2=88%). The D-dimer level determined was 165ng/mL (normal range: 69243 ng/mL). He was evaluated to be at low risk using the Wells Criteria, to have a 2% probability of PE according to the Geneva scoring system when viewed in combination with D-dimer negativity, and PE was excluded using the YEARS algorithm. However, computerized tomography pulmonary angiography revealed PE in 2 main pulmonary arteries. The common scoring systems may fail to recognize PE, which requires treatment. Clinical perception may still be superior.

Keywords: Clinical probability, D-dimer, Diagnostic algorithms, Emergency department, Pulmonary embolism

Olgunun Tomografi Kesitleri




Alten Oskay, Cihangir elik, Kvan Karaman, Hamit Hakan Armaan, nder Tomruk. Is the Diagnosis of Pulmonary Embolism Using Scoring Systems Still a Dilemma?: A Case Report. Respir Case Rep. 2019; 8(1): 17-20

Sorumlu Yazar: Alten Oskay, Trkiye
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