Zusammenfassung
Die akute Hepatitis, das Leberversagen, aber v. a. die akuten Komplikationen einer Leberzirrhose stellen den Notfallmediziner immer wieder vor Herausforderungen, denn die frühzeitige Diagnose und Einleitung einer Ersttherapie bestimmen ganz entscheidend die Prognose der Patienten. Es werden das Notfallmanagement der akuten Hepatitis, deren differenzialdiagnostisches Spektrum von einer asymptomatischen und vorübergehenden Transaminasenerhöhung bis hin zum (relativ seltenen) akuten Leberversagen reicht, sowie die Erstmaßnahmen bei einer dekompensierten Leberzirrhose (Ösophagusvarizenblutung, Aszites, spontane bakterielle Peritonitis, Enzephalopathie) in der Notaufnahme dargestellt.
Abstract
Emergency doctors are often challenged by patients presenting with acute hepatitis, liver failure or acute decompensation of chronic liver disease/cirrhosis. Thus, early diagnosis and early start of treatment will determine outcome of those patients. The clinical presentation may vary from asymptomatic patients with just elevated liver enzymes to patients with signs of acute liver failure, which is relative rare in Germany. More often doctors in the emergency department (ED) are faced by patients with chronic liver disease and cirrhosis presenting with upper gastrointestinal bleeding due to esophageal varices, with ascites, spontaneous bacterial peritonitis or encephalopathy. This CME article will focus on the first diagnostic and therapeutic measures to be taken by emergency physicians when these patients are seen in the ED.
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Interessenkonflikt. M. Muche und R.Somasundaram geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.
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Muche, M., Somasundaram, R. Akute Hepatitis, Leberversagen, akut dekompensierte Leberzirrhose. Notfall Rettungsmed 17, 159–173 (2014). https://doi.org/10.1007/s10049-014-1842-y
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DOI: https://doi.org/10.1007/s10049-014-1842-y