Zusammenfassung
Der Begriff „akutes Abdomen“ stellt keine eigenständige Erkrankung dar, sondern beschreibt einen kritischen klinischen Zustand, unter dessen Oberbegriff sich die unterschiedlichsten Krankheitsbilder subsumieren lassen. Das Zeitintervall zwischen dem Auftreten der ersten Symptome bis zur Einleitung einer gezielten Therapie ist für die Prognose der Patienten der entscheidende Faktor. Aus diesem Grund bestehen besondere Anforderungen an die bildgebende Diagnostik, die dazu beitragen soll, innerhalb kürzester Zeit eine möglichst genaue Diagnose zu stellen. Neben Anamnese, klinischer Untersuchung und Labordiagnostik stellt die radiologische Untersuchung einen wesentlichen Baustein vor der Therapieeinleitung dar. Aus chirurgischer Sicht müssen Krankheitsbilder, die eine sofortige Notfalloperation erforderlich machen, von Erkrankungen differenziert werden, die eine elektive Chirurgie oder ein konservatives Vorgehen indizieren.
Abstract
The term “acute abdomen” does not describe a specific disease entity but is more a critical clinical state which incorporates very heterogeneous clinical presentations. The prognosis of any disease depends on the time frame from the onset of symptoms to the initiation of a specific therapy. For this reason there are special expectations by clinicians regarding the diagnostic assessment provided by radiology which is expected to deliver an immediate diagnosis supporting further therapeutic decisions. Along with the patient’s clinical history, physical examination and blood tests, radiological diagnostics are essential for enabling a specific treatment. From a surgical point of view the radiologist is expected to help in differentiating between cases with indications for emergency surgery and cases eligible for elective surgery or conservative treatment.
Literatur
Tsushima Y, Yamada S, Aoki J et al (2002) Effect of contrast-enhanced computed tomography on diagnosis and management of acute abdomen in adults. Clin Radiol 57:507–513
Abbas SM, Bissett IP, Parry BR (2007) Meta-analysis of oral water-soluble contrast agent in the management of adhesive small bowel obstruction. Br J Surg 94:404–411
Kellow ZS, MacInnes M, Kurzencwyg D et al (2008) The role of abdominal radiography in the evaluation of the nontrauma emergency patient. Radiology 248:887–893
Stoker J, Randen A van, Laméris W, Boermeester MA (2009) Imaging patients with acute abdominal pain. Radiology 253:31–46
Rosen MP, Sands DZ, Longmaid III HE et al (2000) Impact of abdominal CT on the management of patients presenting to the emergency department with acute abdominal pain. AJR Am J Roentgenol 174:1391–1396
Strömberg C, Johansson G, Adolfsson A (2007) Acute abdominal pain: diagnostic impact of immediate CT scanning. World J Surg 31:2347–2354
Doria AS, Moineddin R, Kellenberger CJ et al (2006) US or CT for diagnosis of appendicitis in children and adults? A meta-analysis. Radiology 241:83–94
Kirkpatrick ID, Kroeker MA, Greenberg HM (2003) Biphasic CT with mesenteric CT angiography in the evaluation of acute mesenteric ischemia: initial experience. Radiology 229:91–98
Choi D, Jin Lee S, Ah Cho Y et al (2003) Bowel wall thickening in patients with Crohn’s disease: CT patterns and correlation with inflammatory activity. Clin Radiol 58:68–74
Dhillon S, Halligan S, Goh V et al (2002) The therapeutic impact of abdominal ultrasound in patients with acute abdominal symptoms. Clin Radiol 57:268–271
Laméris W, van Randen A, van Es HW et al (2009) Imaging strategies for detection of urgent conditions in patients with acute abdominal pain: diagnostic accuracy study. BMJ 338:b2431
Ahn SH, Mayo-Smith WW, Murphy BL et al (2002) Acute nontraumatic abdominal pain in adult patients: abdominal radiography compared with CT evaluation. Radiology 225:159–164
Lee KT, Wong SR, Sheen PC (2001) Pyogenic liver abscess: an audit of 10 years‘ experience and analysis of risk factors. Dig Surg 18:459–465
Allison DJ, Jordan H, Hennessy O (1985) Therapeutic embolization of the hepatic artery: a review of 75 procedures. Lancet 1:595–599
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Graeb, C., Reiser, M., Jauch, KW. et al. Akutes Abdomen. Radiologe 50, 209–213 (2010). https://doi.org/10.1007/s00117-009-1900-5
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DOI: https://doi.org/10.1007/s00117-009-1900-5