Skip to main content
SpringerLink
Log in

Stellenwert der Sonographie in der postoperativen Phase

The value of postoperative ultrasonography

  • Leitthema
  • Published:
Der Chirurg Aims and scope Submit manuscript

Zusammenfassung

In der frühpostoperativen Phase ist es wichtig, Komplikationen rechtzeitig zu entdecken. Neben den klinischen und laborchemischen Befunden wird dem Ultraschall als bildgebendem Verfahren eine zunehmende Bedeutung beigemessen. In dieser Arbeit wird der Wert des Ultraschalls zur postoperativen Diagnostik dargestellt. Die Ultraschallbefunde typischer Komplikationen wie Nachblutung, Abszess, akute Cholezystitis, Pankreatitis oder Ileus werden vorgestellt und der Wert des Ultraschalls mit der Computertomographie und Magnetresonanztomographie verglichen. In der Diagnostik von Nachblutung, akuter reaktiver Cholezystitis und postoperativem Ileus weist der Ultraschall eine hervorragende Sensitivität und Spezifität auf (>95%). Zur Beurteilung des Pankreas oder zum Nachweis eines Abszesses ist der Ultraschall der Computertomographie aufgrund der postoperativen Darmatonie unterlegen. Durch die sonographisch gesteuerte Intervention ergibt sich zusätzlich eine therapeutische Möglichkeit.

Abstract

In the early period following surgery, it is very important to reveal any complications. In this article the role of ultrasound in recognizing postoperative complications is demonstrated. Ultrasound findings in typical complications of abdominal surgery such as bleeding, abscess formation, acute cholecystitis, pancreatitis, and postoperative ileus are described. The diagnosis of postoperative bleeding, acute cholecystitis, and ileus is very reliable by ultrasound (sensitivity and specifity >95%). Ultrasonography is inferior to computed tomography in detecting pancreatitis and abscess formation. The guiding of interventions by ultrasound offers additional therapeutic options.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3
Abb. 4
Abb. 5
Abb. 6
Abb. 7

Literatur

  1. Balthazar EJ (2002) Staging of acute pancreatitis. Radiol Clin North Am 40: 1199–1209

    PubMed  Google Scholar 

  2. Bartels H, Siewert JR (1991) [Diagnostic procedure in postoperative complications]. Langenbecks Arch Chir Suppl Kongressbd, S 130–134

  3. Benoist S, Panis Y, Pannegeon V et al. (2002) Can failure of percutaneous drainage of postoperative abdominal abscesses be predicted? Am J Surg 184: 148–153

    Article  PubMed  Google Scholar 

  4. De Vargas MM, Lanciotti S, De Cicco ML et al. (2006) Ultrasonographic and spiral CT evaluation of simple and complicated acute cholecystitis: diagnostic protocol assessment based on personal experience and review of the literature. Radiol Med (Torino) 111: 167–180

    Google Scholar 

  5. Del FC, Zanardi R, Mortele K, Ros PR (2002) Advances in imaging for pancreatic disease. Curr Gastroenterol Rep 4: 140–148

    PubMed  Google Scholar 

  6. Frager D, Medwid SW, Baer JW et al. (1994) CT of small-bowel obstruction: value in establishing the diagnosis and determining the degree and cause. AJR Am J Roentgenol 162: 37–41

    PubMed  Google Scholar 

  7. Furukawa A, Yamasaki M, Furuichi K et al. (2001) Helical CT in the diagnosis of small bowel obstruction. Radiographics 21: 341–355

    PubMed  Google Scholar 

  8. Giangreco L, Di PS, Castrucci M et al. (1997) [Abdominal abscesses: their treatment and the study of prognostic factors]. Minerva Chir 52: 369–376

    PubMed  Google Scholar 

  9. Gurleyik G, Emir S, Kilicoglu G et al. (2005) Computed tomography severity index, APACHE II score, and serum CRP concentration for predicting the severity of acute pancreatitis. JOP 6: 562–567

    PubMed  Google Scholar 

  10. Inoue T, Kitano M, Kudo M et al. (2007) Diagnosis of gallbladder diseases by contrast-enhanced phase-inversion harmonic ultrasonography. Ultrasound Med Biol (in press)

  11. Jansen M, Truong S, Riesener KP et al. (1999) [Results of sonographically guided percutaneous catheter drainage of intra-abdominal abscesses in surgery]. Chirurg 70: 1168–1171

    Article  PubMed  Google Scholar 

  12. Khurrum BM, Hua ZR, Batista O et al. (2002) Percutaneous postoperative intra-abdominal abscess drainage after elective colorectal surgery. Tech Coloproctol 6: 159–164

    Article  PubMed  Google Scholar 

  13. Kidmas AT, Ekedigwe JE, Sule AZ, Pam SD (2005) A review of the radiological diagnosis of small bowel obstruction using various imaging modalities. Niger Postgrad Med J 12: 33–36

    PubMed  Google Scholar 

  14. Kwon RS, Scheiman JM (2006) New advances in pancreatic imaging. Curr Opin Gastroenterol 22: 512–519

    Article  PubMed  Google Scholar 

  15. Lin CM, Hung GU, Chao TH et al. (2005) The limited use of ultrasound in the detection of abdominal abscesses in patients after colorectal surgery: compared with gallium scan and computed tomography. Hepatogastroenterology 52: 79–81

    PubMed  Google Scholar 

  16. Lo SS, Wu CW, Shen KH et al. (2002) Higher morbidity and mortality after combined total gastrectomy and pancreaticosplenectomy for gastric cancer. World J Surg 26: 678–682

    Article  PubMed  Google Scholar 

  17. Maconi G, Sampietro GM, Parente F et al. (2003) Contrast radiology, computed tomography and ultrasonography in detecting internal fistulas and intra-abdominal abscesses in Crohn’s disease: a prospective comparative study. Am J Gastroenterol 98: 1545–1555

    Article  PubMed  Google Scholar 

  18. Marietta M, Facchini L, Pedrazzi P et al. (2006) Pathophysiology of bleeding in surgery. Transplant Proc 38: 812–814

    Article  PubMed  Google Scholar 

  19. Musoke F, Kawooya MG, Kiguli-Malwadde E (2003) Comparison between sonographic and plain radiography in the diagnosis of small bowel obstruction at Mulago Hospital, Uganda. East Afr Med J 80: 540–545

    PubMed  Google Scholar 

  20. Noone TC, Semelka RC, Chaney DM, Reinhold C (2004) Abdominal imaging studies: comparison of diagnostic accuracies resulting from ultrasound, computed tomography, and magnetic resonance imaging in the same individual. Magn Reson Imaging 22: 19–24

    Article  PubMed  Google Scholar 

  21. Suri S, Gupta S, Sudhakar PJ et al. (1999) Comparative evaluation of plain films, ultrasound and CT in the diagnosis of intestinal obstruction. Acta Radiol 40: 422–428

    PubMed  Google Scholar 

  22. Truong S, Arlt G, Pfingsten F, Schumpelick V (1992) [Importance of sonography in diagnosis of ileus. A retrospective study of 459 patients]. Chirurg 63: 634–640

    PubMed  Google Scholar 

  23. Tsai SC, Chao TH, Lin WY, Wang SJ (2001) Abdominal abscesses in patients having surgery: an application of Ga-67 scintigraphic and computed tomographic scanning. Clin Nucl Med 26: 761–764

    Article  PubMed  Google Scholar 

  24. Witzigmann H, Geissler F, Uhlmann D, Hauss J (1998) [Intra-abdominal abscess]. Chirurg 69: 813–820

    Article  PubMed  Google Scholar 

  25. Yu PC, Ko SF, Lee TY et al. (2002) Small bowel obstruction due to incarcerated sciatic hernia: ultrasound diagnosis. Br J Radiol 75: 381–383

    PubMed  Google Scholar 

Download references

Interessenkonflikt

Es besteht kein Interessenkonflikt. Der korrespondierende Autor versichert, dass keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, bestehen. Die Präsentation des Themas ist unabhängig und die Darstellung der Inhalte produktneutral.

Author information

Authors and Affiliations

  1. Klinik und Poliklinik für Chirurgie der RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland

    S. Truong, J. Grommes, J. Conze & V. Schumpelick

Authors
  1. S. Truong
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. Grommes
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. Conze
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. V. Schumpelick
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S. Truong.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Truong, S., Grommes, J., Conze, J. et al. Stellenwert der Sonographie in der postoperativen Phase. Chirurg 78, 443–448 (2007). https://doi.org/10.1007/s00104-007-1333-5

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00104-007-1333-5

Schlüsselwörter

Keywords

Search

Navigation