1112

Die Abdomensonographie in der Primardiagnostik des stumpfen Bauchtraumas P Sctmorkowski I , D, Br('dll ·Krm~Jf ~~. . t. Gokhnann'. .I M. Friedrich', J l.innncr-'

Ultr asou nd in the Primary l) ia~lI()si s or Blunt A bdo m ina lTra um a 200 pa tien ts wi th blu nt ab do mi nal trauma werc sca nned by ultra so und primari ly. 152 showed a norm a l sonogr aphic ex a mination. In 24 patients all organic inj ury was visualised. Th ese 20 splenic inj ur ies. 2 les ions of the k idne y. I splenic an d rena l lesion an d I hepatic a nd splen ic rup ture were confirmed by CT in 9 ca ses. by lap a ro to my in 9 cases. by sonographic rO IlOW ~ ll P in 2 cas es. 23 pati ent s showed a n intraa bdomina l fl uid co lle ctio n. in 16 pa tients a decrease wa s see n by ultraso und. 7 pa tien ts were dire ctly operat ed o n because ofa visible inc rease of inIraab dom ina l fl uid . T he lesions cons isted o f 3 hepatic ruptures. 2 retro perit onea l ble edings . Ultras ound is a relia ble too l in the dia g nosis o f blunt ab do mi nul trauma on the da y of ad mi tta nce and in the eva luatio n o f inj uries in res pec t of opera tive or co nse rvative mana ge men t.

Z usa nuncntassu ng 200 Paticn ten m it cin cm stum pfcn Haucht raurna w urdcn pri miir so nog raphisc h untc rsucht . 152 zc igten cine n unau ffiill igcn Bc fund. Ein d irek ter Nac hwe is vo n Organ vcrlct zungc n gela ng bc i 24 Paticn tcn. Dicsc 20 Milz verlctz ungen. 2 Niercn vcrlctzungcn. 1 Nicrcn- lind Milz vcrlct zung un d I Leber- und Milzruptur wur dcn in 9 Hillen dur ch d ie Co mput crt omogra phic bcsta rigt. in 3 Hillen durch d ie Lap arotomi c lind in 2 Hill en dur ch die sc nog rap hisc hc Vcr taufskontrol lc. Bei 23 Paticutcn lieU sich iruraabdomin cll frcic FHiss igkeil nuchwciscn . in 16 Fallen war cin Riickgang del' Plllssi gkcit so nog raphisch da rstcllb ar, 7 Pat ie nten wu rdcn aufg rund del' sich tbarc n H iissigkcitsmcn gc so fon lnparotomic n . llicrbci bandc hc cs sich um 3 Lcbcrrupturcn. 2 rctro pcriton calc BIIItungcn . 1 Pnnkrcns- und l la rn bla scnvcrlctz ung lind 1 Dannvcrlctzung. Die So nogruphic e rwe is t sich als zuvcrlassi gc Untc rsuch un gsm ct hud c in del' Diag no st ik des stum pfcn Bauchtrau ma s am Unfal hag lind zum Nac hwe is opcrationsbcdilrftige l' Vcrlctzungcn.

Key nunls

Se llIilsselw [irter

Blunt abdo mi na l trauma - Abdo mina l bleeding

S tum pfcs Baucht rauma - Abdominalbl utung

Elnlclt u ug

DcI' frllhzcit igcu Erkc nnun g ciu cr Verletz ung

im Abdome n bci Paticntcn m it cincm stumpfcn Bauchtmuma kommt cntschcidcndc Bed eu tu ng zu in bczug a u f das therapcutisc he Vorg ch cn lind d ie Prog nosc. Nc bc n del' klinisch cn Untcrsuc hung stc hcn hier vcrsc hicdc nc bildgcbc ndc Vcrfa hrcn wic die Abdomcnubcrsicht, de l' Uhrascha ll, di e Co mputert omogruphic lind di e Angiogra phie z ur Vcrfllgung. Insbeso nd ere die Ultrascha lluntcrsuchung eigne t sich als zcitsparcndcs und aussagc kriifti gcs bild gcbcnd cs Verfa hrc n. we lches sim uhan zu den erforde rlichen Notfallmallnahmcn und oh ne zusa tz lic he Bela stung des Pati cn tcn eingcsctzt worde n ka nn. 1m Ra hmen c ineI' prospck tivcn S tud ic ha bc n w ir d ic Sonog raphic bcz Ugli c h ihrcr Alissagekra fi zu r Diagnostik a hdo mi ncl lc r Vcrle tzu ngen libe rpriifi.

Ultrasc ha ll in Me

[Abdominal sonography in primary diagnosis of blunt abdominal trauma].

200 patients with blunt abdominal trauma were scanned by ultrasound primarily. 152 showed a normal sonographic examination. In 24 patients an organic ...
1MB Sizes 0 Downloads 0 Views