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Point-of-care-Sonographie des Abdomens in der Notfall- und Intensivmedizin

Point-of-care ultrasonography of the abdomen in emergency and intensive care medicine

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Zusammenfassung

Die Point-of-care-Sonographie ist zu einer nicht mehr wegzudenkenden Säule in der Diagnostik, Therapieeinleitung und -steuerung in der Notfall- und Intensivmedizin geworden. Die Verbesserung der Leistungsfähigkeit und Mobilität der modernen Ultraschallgeräte ermöglicht eine qualitativ hochwertige Bildgebung unmittelbar am Patientenbett. Der Fokus der Point-of-care-Sonographie liegt nicht auf einer erschöpfenden differenzialdiagnostischen Abdomensonographie. Vielmehr geht es um die Einordnung auch für den weniger geübten Untersucher erkennbarer sonographischer Befunde in den klinischen Kontext. Hieraus erfolgt die Ableitung der weiteren erforderlichen diagnostischen oder therapeutischen Maßnahmen. Der vorliegende Artikel zeigt die Möglichkeiten und Grenzen der Methode auf. Die Gliederung orientiert sich an den jeweils vorliegenden klinischen Leitsymptomen. Der Schwerpunkt liegt auf der Ultraschallschnittführung und dem Ablauf der Untersuchung sowie den zu erwartenden Befunden mit illustrierendem Bildmaterial. Es folgt eine kurze Abhandlung der differenzialdiagnostischen Einordnung. Die abzuleitende weiterführende Diagnostik oder Therapie wird ebenfalls kurz angesprochen.

Abstract

Point-of-care ultrasound is a fundamental part of diagnostic and therapeutic management in emergency and intensive care medicine. The availability of high-resolution mobile ultrasound systems allows high-quality imaging at the bedside of the patient. Point-of-care ultrasound is not a comprehensive differential diagnostic abdominal ultrasound examination. Rather, the aim of the method is to integrate easily detectable sonographic findings into the clinical context. From this, the necessary diagnostic or therapeutic procedures are derived. This article shows opportunities and limitations of this method. The structure of the article is given by the leading clinical symptoms. The focus is on the ultrasound examination and the characteristic sonographic findings with illustrative ultrasound images. This is followed by a short differential diagnostic interpretation. Further diagnostic or therapeutic management is also briefly addressed.

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Authors and Affiliations

  1. Sektion Interdisziplinäre Intensivmedizin, Sana Kliniken Lübeck GmbH, Kronsforder Allee 71–73, 23560, Lübeck, Deutschland

    M. Milkau &  F. Sayk

  2. Medizinische Klinik I, Sana Kliniken Lübeck GmbH, Kronsforder Allee 71–73, 23560, Lübeck, Deutschland

    M. Milkau &  T. Noll

Authors
  1. M. Milkau
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  2. T. Noll
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  3. F. Sayk
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Correspondence to F. Sayk.

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M. Milkau, T. Noll und F. Sayk geben an, dass kein Interessenkonflikt besteht.

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

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M. Buerke, Siegen

C. Dodt, München

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Milkau, M., Noll, T. & Sayk, F. Point-of-care-Sonographie des Abdomens in der Notfall- und Intensivmedizin. Med Klin Intensivmed Notfmed 113, 638–648 (2018). https://doi.org/10.1007/s00063-018-0491-1

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  • DOI: https://doi.org/10.1007/s00063-018-0491-1

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