Stumpfes Thoraxtrauma (Frakturen: Sternum, Rippen, Zwerchfellruptur, Innere Organe)

Hillejan, Ludger

doi:10.1007/978-3-662-59159-8_28-1

Ludger Hillejan⁴

Part of the book series: Springer Reference Medizin ((SRM))

38 Accesses

Zusammenfassung

In Deutschland überwiegt unter den Thoraxtraumen das stumpfe Thoraxtrauma. Neben knöchernen Verletzungen (Rippen und Sternum) resultieren solche der Lunge (Kontusion, Lazeration, Hämatom, gegebenenfalls mit Pneumo- und/oder Hämatothorax), des Zwerchfells, der großen Atemwege und der thorakalen Gefäße. Die überwiegende Mehrheit der Patienten können konservativ behandelt werden. Kernpunkte sind: Schmerztherapie, optimale Flüssigkeitssubstitution, Bronchialhygiene, Physiotherapie, Krankengymnastik, Sauerstoffsubstitution bei Hypoxämie. Der häufigste Eingriff ist die Einlage einer Thoraxdrainage. Muss operiert werden, sind anstelle einer Thorakotomie zunehmend häufiger minimalinvasive videothorakoskopische Interventionen möglich: Übernähung oder Keilresektion der Lunge, Naht des Zwerchfells oder kleinerer Gefäße, Evakuation eines Hämatothorax. Ausgedehntere Resektionen sind selten und mit einer schlechteren Prognose verbunden. Nur eine Minderheit der Rippen- und Sternumfrakturen, z. B. bei größeren instabilen Brustwandsegmenten (Flail Chest), müssen operativ stabilisiert werden.

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Klinik für Thoraxchirurgie und thorakale Endoskopie, Niels-Stensen-Kliniken, Ostercappeln, Deutschland
Ludger Hillejan

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Ludger Hillejan
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Correspondence to Ludger Hillejan .

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Sektion Thoraxchirurgie, Klinikum rechts der Isar der Technischen Universität München, München, Bayern, Deutschland
Hans Hoffmann
Klinik für Thoraxchirurgie, Florence-Nightingale-Krankenhaus, Düsseldorf, Nordrhein-Westfalen, Deutschland
Corinna Ludwig
Klinik für Thoraxchirurgie, Universitätsklinikum Freiburg, Freiburg im Breisgau, Baden-Württemberg, Deutschland
Bernward Passlick

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Klinik für Allgemein-, Viszeral- und Thoraxchirurgie, BundeswehrZentralkrankenhaus Koblenz, Koblenz, Deutschland
Robert Schwab FACS
Florence Nightingale Krankenhaus, Düsseldorf, Deutschland
Corinna Ludwig

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Hillejan, L. (2022). Stumpfes Thoraxtrauma (Frakturen: Sternum, Rippen, Zwerchfellruptur, Innere Organe). In: Hoffmann, H., Ludwig, C., Passlick, B. (eds) Thoraxchirurgie. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-59159-8_28-1

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DOI: https://doi.org/10.1007/978-3-662-59159-8_28-1
Received: 21 February 2021
Accepted: 03 January 2022
Published: 13 December 2022
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-662-59159-8
Online ISBN: 978-3-662-59159-8
eBook Packages: Springer Referenz Medizin

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