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Evidenzbasierte Diagnostik des abdominellen Traumas

Evidence-based diagnosis of abdominal trauma

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Zusammenfassung

Das Trauma des Abdomens ist insbesondere bei Patienten unter 40 Jahren eine häufige Todesursache. Die rasche Erstellung aussagekräftiger radiologischer Befunde ist unerlässlich, um die Mortalität zu senken. Die Sonographie wird heute nur mehr bei Bagatelltraumen und als „focused assessment with sonography for trauma“ (FAST) zur Abklärung freier intraperitonealer Flüssigkeit unmittelbar nach dem Eintreffen schwer verletzter Patienten verwendet. Hingegen hat die Radiologie mit der Multidetektorcomputertomographie (MDCT) ein geeignetes Instrument zur Verfügung, um seine Rolle für die Triage zur operativen oder konservativen Behandlung von Patienten nach Trauma des Abdomens erfüllen zu können. Die therapeutischen Entscheidungen werden wesentlich von Verletzungsscores bestimmt, mit denen der Radiologe zusammen mit den sich daraus ergebenden Konsequenzen vertraut sein muss.

Abstract

Abdominal trauma is a common cause of death particularly in patients up to 40 years of age. In order to reduce mortality a rapid radiologic diagnosis is essential. At present, sonography plays a role only in the evaluation of minor trauma and as a “focused assessment with sonography for trauma” (FAST) to clarify free intraperitoneal fluid immediately on admittance in severely injured patients. However, computed tomography has proven to be a potent tool for the triage of patients with abdominal trauma, because, based on the results of the CT scan, patients can be referred for laparotomy or safely classified for “wait and see” treatment. Therapeutic decisions are largely based on injury severity scores and the radiologist must be familiar with them as well as with the associated therapeutic consequences.

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  1. Univ.-Klinik für Radiodiagnostik, Medizinische Universität Wien, Währinger Gürtel 18–20, 1090, Wien, Österreich

    G. Schueller

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Schueller, G. Evidenzbasierte Diagnostik des abdominellen Traumas. Radiologe 48, 474–479 (2008). https://doi.org/10.1007/s00117-008-1657-2

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