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Radiologische Akutdiagnostik bei Darmobstruktion

Emergency radiology of bowel obstruction

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Zusammenfassung

In der dringlichen Diagnostik von Darmpassagestörungen nimmt die Radiologie eine zentrale Position ein. In Kombination mit Anamnese, klinischer Untersuchung und Laborwerten ist die Abdomenübersichtsaufnahme die unverzichtbare Basis zur Festlegung des weiteren Vorgehens. Steht auf dieser Grundlage die Diagnose fest und besteht akuter operativer Handlungsbedarf, kann auf eine weitere Bildgebung verzichtet werden. Ansonsten ist die Mehrschicht-CT aufgrund ihres breiten diagnostischen Spektrums die weiterführende Methode der Wahl. Ist die CT nicht verfügbar, muss bei Verdacht auf Kolonobstruktion ein Kontrastmitteleinlauf erfolgen. Der Stellenwert der herkömmlichen Verfolgung der Passage oraler wasserlöslicher Kontrastmittel ist gering.

Abstract

Clinical radiology is a key to the management of bowel obstruction. Plain abdominal radiographs combined with history, clinical exam, and laboratory findings are essential for further individualized strategies. If the cause of obstruction is obvious after plain films and there is a need for emergent surgery, no further imaging is required. In all other cases, multislice CT with at least intravenous and rectal contrast is the method of choice due to its broad diagnostic spectrum. If CT is not available, contrast enema is recommended in suspected large bowel obstruction. Oral administration of water-soluble contrast agents has no significant value in the workup of bowel obstruction.

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Danksagung

Herrn Dr. H.-P. Weskott, Hannover, wird für die Überlassung der sonographischen Abbildungen gedankt.

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  1. Chefarzt der Klinik für Diagnostische und Interventionelle Radiologie, Henriettenstiftung, Marienstraße 72–90, 30171 , Hannover, Deutschland

    P. Landwehr

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  1. P. Landwehr
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Correspondence to P. Landwehr.

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Landwehr, P. Radiologische Akutdiagnostik bei Darmobstruktion. Chirurg 77, 889–897 (2006). https://doi.org/10.1007/s00104-006-1232-1

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