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Bildgebende Diagnostik bei akuter Pankreatitis

Imaging diagnostics in acute pancreatitis

Zusammenfassung

Die abdominelle Bildgebung ist bei der akuten Pankreatitis ein wichtiger Bestandteil der Diagnostik. Neben Klinik und Laborkonstellation dient sie der Etablierung der Diagnose bzw. dem Ausschluss anderer Erkrankungen und darüber hinaus der Identifikation und Verlaufsbeurteilung lokaler Komplikationen sowie vaskulärer Veränderungen, die im Rahmen einer akuten Pankreatitis entstehen können. Aufgrund der zahlreichen zur Verfügung stehenden bildgebenden Untersuchungsmethoden, deren Kombinationsmöglichkeiten sowie der unterschiedlichen Untersuchungszeitpunkte ergeben sich diverse Möglichkeiten der Anwendung, die viele Faktoren wie etwa Krankheitsschwere und -dauer, Begleiterkrankungen sowie Komplikationen der akuten Pankreatitis berücksichtigen müssen. Eine rationale Nutzung der Bildgebung ist eine wichtige Voraussetzung für eine qualitativ hochwertige und gleichzeitig kosteneffektive Patientenversorgung. In der vorliegenden Übersicht wird der aktuelle Stellenwert der Bildgebung bei der akuten Pankreatitis zusammengefasst, unter besonderer Berücksichtigung der aktualisierten S3-Leitlinie zur akuten Pankreatitis.

Abstract

Abdominal imaging is an important component of the diagnostics of acute pancreatitis. In addition to the clinical features and the laboratory constellation, it serves to establish the diagnosis or the exclusion of other diseases and also the identification and assessment of the course of local complications and vascular changes that can arise during the course of acute pancreatitis. Due to the numerous imaging examination methods that are available, their combination options and the different examination times, there are diverse application options that have to be taken into account, such as the severity and duration of the disease, concomitant diseases and complications of acute pancreatitis. A rational use of imaging is an important prerequisite for high quality and at the same time cost-effective patient care. This review summarizes the current importance of imaging in acute pancreatitis, with particular reference to the updated S3 guidelines on acute pancreatitis.

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Correspondence to Ali A. Aghdassi.

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A.A. Aghdassi und M. Seidensticker geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Markus M. Lerch, München

Joachim Mössner, Leipzig

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Aghdassi, A.A., Seidensticker, M. Bildgebende Diagnostik bei akuter Pankreatitis. Internist 62, 1044–1054 (2021). https://doi.org/10.1007/s00108-021-01153-3

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Schlüsselwörter

  • Komplikationen der akuten Pankreatitis
  • Abdomensonographie
  • Endoskopischer Ultraschall
  • Computertomographie
  • Magnetresonanztomographie/Magnetresonanz-Cholangiopankreatikographie

Keywords

  • Complications of acute pancreatitis
  • Abdominal ultrasound
  • Endoscopic ultrasound
  • Computed tomography
  • Magnetic resonance imaging/magnetic resonance cholangiopancreatography