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Bildgebung des stumpfen Thoraxtraumas

Imaging of blunt chest trauma

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Zusammenfassung

Klinisches Problem

Stumpfe Thoraxtraumen gehen mit einer hohen Morbidität und Mortalität einher. Daher sollten Patienten mit Verdacht auf ein stumpfes Thoraxtrauma rasch radiologisch untersucht werden, damit die entsprechenden therapeutischen Schritte zeitgerecht eingeleitet werden können.

Therapeutische Standardverfahren

Zur Abklärung von Patienten nach einem stumpfen Thoraxtrauma sind seit Jahren das konventionelle Lungenröntgen und die Computertomographie bewährte Verfahren.

Methodische Innovationen

In den letzten Jahren hat die fokussierte Ultraschalluntersuchung (eFAST, Extended Focused Assessment with Sonography for Trauma) von schwerverletzten Patienten vermehrt an Bedeutung gewonnen.

Empfehlung für die Praxis

Durch eine eFAST-Untersuchung kann in der Akutphase rasch geklärt werden, ob bei dem Patienten ein therapiebedürftiger Pneumothorax, Hämatoperikard oder Hämatothorax vorliegen. Auch das Lungenröntgen wird zur Diagnose eines Pneumothorax oder Hämatothorax eingesetzt, wenngleich seine Sensitivität deutlich eingeschränkt ist. Die CT ist das diagnostische Verfahren der Wahl, um v. a. Patienten mit einem schweren Thoraxtrauma abzuklären.

Abstract

Clinical/methodological issue

Blunt chest trauma is associated with high morbidity and mortality. Consequently, all patients should be evaluated radiologically after blunt chest trauma to allow timely and appropriate treatment.

Standard radiological methods

Conventional chest radiographs and computed tomography (CT) are proven modalities with which to evaluate patients after blunt chest trauma.

Methodological innovations

Over the last several years extended focused assessment with sonography for trauma (eFAST) has gained increasing importance for the initial assessment of seriously injured patients.

Practical recommendations

In the acute phase of severely injured patients eFAST examinations are helpful to exclude pneumothorax, hemothorax and hemopericardium. Chest radiographs may also be used to diagnose a pneumothorax or hemothorax; however, the sensitivity is limited and CT is the diagnostic modality of choice to evaluate severely injured patients.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. H. Prosch und L. Negrin geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Univ.-Klinik für Radiologie und Nuklearmedizin, Medizinische Universität Wien, Allgemeines Krankenhaus, Währingergürtel 18–22, 1090, Wien, Österreich

    H. Prosch

  2. Univ.-Klinik für Unfallchirurgie, Medizinische Universität Wien, Allgemeines Krankenhaus, Wien, Österreich

    L. Negrin

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Correspondence to H. Prosch.

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Prosch, H., Negrin, L. Bildgebung des stumpfen Thoraxtraumas. Radiologe 54, 886–892 (2014). https://doi.org/10.1007/s00117-013-2637-8

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  • DOI: https://doi.org/10.1007/s00117-013-2637-8

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