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Diagnostik und Therapie des akuten Abdomens

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Weiterbildung Intensivmedizin und Notfallmedizin

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Zusammenfassung

Sowohl für den Notaufnahmearzt als auch den Intensivmediziner stellt der Patient mit einem „akuten Abdomen“ eine besondere Herausforderung dar. Dabei ist der sog. brettharte Bauch Resultat einer sekundären Peritonitis, die zwangsläufig in einer intraabdominellen Sepsis gipfelt. Diese kritisch kranken Patienten profitieren von einer möglichst raschen Diagnostik und interdisziplinären Therapie. Die Gruppe der Patienten mit einer postoperativen Peritonitis (z. B. nach Anastomoseninsuffizienz) weist oftmals ein maskiertes klinisches Bild auf, das ein Grund für die inakzeptabel hohe Letalität ist.

Nach Durchlaufen einer Standarddiagnostik wird die Indikation zur Computertomographie früh gestellt, da sie zusätzlich zur Fokussuche bereits eine Operationsplanung und ggf. eine radiologisch-interventionelle Drainageeinlage erlaubt. Die Therapie fußt auf 3 elementaren Säulen: der raschen Fokussanierung, einer breiten Antibiotikatherapie und den supportiven intensivmedizinischen Maßnahmen.

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Author information

Authors and Affiliations

  1. Klinik für Allgemein-, Viszeral-, Thorax-, Transplantations- und Kinderchirurgie, Universitätsklinikum Gießen und Marburg GmbH, Standort Gießen

    A. Hecker, K. Kipfmüller, J. Holler, M. Reichert & W. Padberg

  2. Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum Gießen und Marburg GmbH, Standort Gießen

    B. Hecker, E. Schneck & M.A. Weigand

  3. Medizinische Klinik II, Universitätsklinikum Gießen und Marburg GmbH, Standort Gießen

    M. Hecker

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  1. A. Hecker
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  2. B. Hecker
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  3. K. Kipfmüller
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  4. J. Holler
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  5. E. Schneck
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  6. M. Reichert
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  7. M.A. Weigand
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  8. W. Padberg
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  9. M. Hecker
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Editor information

Editors and Affiliations

  1. Klinik für Innere Medizin, St. Antonius-Hospital, Dechant-Deckers-Str. 8, 52249, Eschweiler

    U. Janssens

  2. Univ.-Klinik für Innere Medizin I, Universitätsklinikum Innsbruck, Aichstr. 35, A-6020, Innsbruck

    M. Joannidis

  3. Med. Klinik und Poliklinik II, Universitätsklinikum Gießen, Klinikstr. 36, 35392, Gießen

    K. Mayer

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Hecker, A. et al. (2015). Diagnostik und Therapie des akuten Abdomens. In: Janssens, U., Joannidis, M., Mayer, K. (eds) Weiterbildung Intensivmedizin und Notfallmedizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-46521-9_8

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  • DOI: https://doi.org/10.1007/978-3-662-46521-9_8

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-46520-2

  • Online ISBN: 978-3-662-46521-9

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