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Vorgehen bei Leber‑, Milz‑ und Pankreasverletzungen inklusive „damage control surgery“ bei Terroranschlägen

Approach to liver, spleen and pancreatic injuries including damage control surgery of terrorist attacks

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Zusammenfassung

Hintergrund

Die Terroranschlagwelle in Europa lässt nicht nach. Geprägt durch die Erfahrungen aus Kriegsgebieten und den aktuellen Ereignissen ist ein Verständnis für die spezielle Situation des Terroranschlagtraumas und seiner Behandlung notwendig.

Methode

Anhand einer kurzen Übersicht über die aktuelle Datenlage zum Thema wird das Damage-control-Prinzip für die einzelnen Organsysteme mit praktischen Tipps aus der Perspektive einer spezialisierten hepatobiliären Chirurgie dargestellt.

Schlussfolgerung

Die Beschäftigung mit der neuen Entität des Anschlagtraumas und der Konsequenz der „blast injury“ ist für jeden Chirurgen notwendig. Dabei kommt es nicht nur auf die medizinische Versorgung, sondern auch auf die Überlegungen zum Umgang mit den Verletzungen in einer Ressourcenmangelsituation an. Im Bereich von Leber und Pankreas ist die Anwendung einfacher Methoden zur Kontrolle der Verletzungen Erfolg versprechend.

Abstract

Background

Terrorist attacks have outreached to Europe with more and more attacks on civilians. Derived from war surgery experience and from lessons learned from major incidents, it seems mandatory for every surgeon to improve understanding of the special circumstances of trauma following a terrorist attack and its’ management.

Method

A short literature review is followed by outlining the damage control surgery (DCS) principle for each organ system with practical comments from the perspective of a specialized hepatobiliary (HPB) surgery unit.

Conclusion

Every surgeon has to become familiar with the new entities of blast injuries and terrorist attack trauma. This concerns not only the medical treatment but also tailoring surgical treatment with a view to a lack of critical resources under these circumstances. For liver and pancreatic trauma, simple treatment strategies are a key to success.

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Author information

Correspondence to G. A. Stavrou.

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Interessenkonflikt

G. A. Stavrou, M.J. Lipp und K. J. Oldhafer geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Stavrou, G.A., Lipp, M.J. & Oldhafer, K.J. Vorgehen bei Leber‑, Milz‑ und Pankreasverletzungen inklusive „damage control surgery“ bei Terroranschlägen. Chirurg 88, 841–847 (2017). https://doi.org/10.1007/s00104-017-0503-3

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Schlüsselwörter

  • Terroranschlagtrauma
  • Damage-control-Strategie
  • Explosionsverletzung
  • Ressourcenmangel
  • Blutungsschock

Keywords

  • Terrorist attack trauma
  • Damage control strategy
  • Blast injuries
  • Lack of resources
  • Hemorrhagic shock