Skip to main content
SpringerLink
Log in

Akutes Abdomen

Acute abdomen

  • Leitthema
  • Published:
Intensivmedizin und Notfallmedizin

Zusammenfassung

Das akute Abdomen ist ein Symptomenkomplex, hinter dem sich zahlreiche Bagatellerkrankungen, aber ebenso zahlreiche vital bedrohliche Störungen verbergen können. Jeder Patient mit akutem Abdomen muss schnellstmöglich einer symptomatischen Therapie und der erforderlichen Diagnostik mit letztlich kausaler Therapie zugeführt werden. Schrittmacher und Weichensteller hierfür ist der in der Akutmedizin tätige Arzt. Um das adäquate Management des akuten Abdomens zu gewährleisten und zu verbessern, ist die interdisziplinäre Teamarbeit unerlässlich.

Abstract

Acute abdomen is a symptom complex that can mask not only numerous minor illnesses, but can also numerous life-threatening disorders. Every patient with acute abdomen must be treated as quickly as possible after diagnostics have been performed. The critical care physician is important for timely diagnosis and decision-making. In order to guarantee and improve adequate management of acute abdomen, an interdisciplinary team is essential.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2

Literatur

  1. Gerhardt RT, Nelson BK, Keenan S et al (2005) Derivation of a clinical guideline for the assessment of nonspecific abdominal pain: the Guideline for Abdominal Pain in the ED Setting (GAPEDS) phase 1 study. Am J Emerg Med 23(6):709–717

    Article  PubMed  Google Scholar 

  2. Reng M, Lock G, Messmann H (1998) Präklinische Notfallmedizin. Internist 39:161–170

    Article  CAS  PubMed  Google Scholar 

  3. Ohmann C, Kraemer M, Jäger S et al (1992) Akuter Bauchschmerz – standardisierte Befundung als Diagnoseunterstützung. Chirurg 63:113–123

    CAS  PubMed  Google Scholar 

  4. Navarro Fernández JA, Tárraga López PJ, Rodríguez Montes JA, López Cara MA (2009) Validity of tests performed to diagnose acute abdominal pain in patients admitted at an emergency department. Rev Esp Enferm Dig 101:610–668

    Article  Google Scholar 

  5. Lukens TW, Emerman C, Effron D (1993) The natural history and clinical findings in undifferentiated abdominal pain. Ann Emerg Med 22(4):690–696

    Article  CAS  PubMed  Google Scholar 

  6. Weiner JB, Nagurney JT, Brown DF et al (2004) Duration of symptoms and follow-up patterns of patients discharged from the emergency department after presenting with abdominal or flank pain. Fam Pract 21(3):314–316

    Article  PubMed  Google Scholar 

  7. Dombal FT (1994) Acute abdominal pain in the elderly. J Clin Gastroenterol 19:331–335

    Article  PubMed  Google Scholar 

  8. Laurell H, Hansson LE, Gunnarsson U (2006) Acute abdominal pain among elderly patients. Gerontology 52(6):339–344

    Article  CAS  PubMed  Google Scholar 

  9. Cicco NA, Hasenfuß G, Just H (1997) Diagnostik und Therapie des akuten Abdomens. Intensivmedizin 34(3):237–242

    Article  Google Scholar 

  10. Miettinen P, Pasanen P, Lahtinen J, Alhava E (1996) Acute abdominal pain in adults. Ann Chir Gynaecol 85(1):5–9

    CAS  PubMed  Google Scholar 

  11. Frieling T (2009) Das akute Abdomen aus internistischer Sicht. Dtsch Med Wochenschr 134(6):246–250

    Article  CAS  PubMed  Google Scholar 

  12. Lalor PF, Mann BD (2007) Splenic rupture after colonoscopy. JSLS 11(1):151–156

    PubMed  Google Scholar 

  13. Bollheimer LC, Reng CM (2004) Die akuten hepatischen Porphyrien in der Notfall- und Intensivmedizin. Intensivmed Notfallmed 41:6

    Article  Google Scholar 

  14. Scott-Conner CEH, Fabrega AJ (1996) Gastrointestinal problems in the immunocompromised host. Surg Endosc 10:959–964

    Article  CAS  PubMed  Google Scholar 

  15. Sudhakar CB, Al-Hakeem M, MacArthur JD et al (1997) Mesenteric ischemia secondary to cocaine abuse: case reports and literature review. Am J Gastroenterol 92:1053–1054

    CAS  PubMed  Google Scholar 

  16. Papi C, Candia S, Masci P et al (1999) Acute ischaemic colitis following intravenous cocaine use. Ital J Gastroenterol Hepatol 31:305–307

    CAS  PubMed  Google Scholar 

  17. Chui PT (1999) Anaesthesia in a patient with undiagnosed salicylate poisoning presenting as intraabdominal sepsis. J Clin Anesth 11:251–153

    Article  CAS  PubMed  Google Scholar 

  18. El-Amin AM, Yahia A-SM, Zaki ZM (1998) Acute abdomen in pregnancy. Int J Gynaecol Obstet 62:31–36

    Google Scholar 

  19. Wilcox CM, Alexander LN, Cotsonis GA (1997) Nonsteroidal antiinflammatory drugs are associated with both upper and lower gastrointestinal bleeding. Dig Dis Sci 42:990–997

    Article  CAS  PubMed  Google Scholar 

  20. Böhner H, Yang Q, Franke K (1994) Bedeutung anamnestischer Angaben und klinischer Befunde für die Diagnose der akuten Appendizitis. Z Gastroenterol 32:579–583

    PubMed  Google Scholar 

  21. Biolato M, Miele L, Gasbarrini G, Grieco A (2009) Abdominal angina. Am J Med Sci 338(5):389–395

    Article  PubMed  Google Scholar 

  22. Gonuguntla V, Joshi DD (2009) Rapunzel syndrome: a comprehensive review of an unusual case of trichobezoar. Clin Med Res 7(3):99–102

    Article  PubMed  Google Scholar 

  23. Lock G, Schölmerich J (1995) Non-occlusive mesenteric ischemia. Hepatogastroenterology 42:234–239

    CAS  PubMed  Google Scholar 

  24. Assar AN, Zarins CK (2009) Ruptured abdominal aortic aneurysm: a surgical emergency with many clinical presentations. Postgrad Med J 85(1003):268–273

    Article  CAS  PubMed  Google Scholar 

  25. Kremer K, Kraemer M, Fuchs KH et al (1998) The diagnostic value of rectal examination of patients with acute appendicitis. Langenbecks Arch Suppl Kongressbd 115:1120–1122

    CAS  Google Scholar 

  26. Gade J, Kruse P, Andersen OT et al (1998) Physicians‘ abdominal auscultation. A multi-rater agreement study. Scand J Gastroenterol 33(7):773–777

    Article  CAS  PubMed  Google Scholar 

  27. Napolitano L, Waku M, Liddo G, Innocenti P (2008) Laparoscopic approach to acute abdomen: a single-center clinical experience. G Chir 29(1–2):47–50

    Google Scholar 

  28. Rösch W (1985) Das akute Abdomen: II. Aus der Sicht des Internisten. Dtsch Ärztebl 81:B-351–B-354

    Google Scholar 

  29. Frank B, Gottlieb K (1999) Amylase normal, lipase elevated: is it pancreatitis? A case series and review of the literature. Am J Gastroenterol 94(2):463–469

    CAS  PubMed  Google Scholar 

  30. Lock G (2001) Acute intestinal ischaemia. Best Pract Res Clin Gastroenterol 15(1):83–98

    Article  CAS  PubMed  Google Scholar 

  31. Wang HP, Chen SC (2007) Upper abdominal ultrasound in the critically ill. Crit Care Med 35(5 Suppl):S208–S215

    Article  PubMed  Google Scholar 

  32. Partrick DA, Janik JE, Janik JS et al (2003) Increased CT scan utilization does not improve the diagnostic accuracy of appendicitis in children. J Pediatr Surg 38(5):659–662

    Article  PubMed  Google Scholar 

  33. Flum DR, Morris A, Koepsell T, Dellinger EP (2001) Has misdiagnosis of appendicitis decreased over time? A population-based analysis. JAMA 286(14):1748–1753

    Article  CAS  PubMed  Google Scholar 

  34. Stengel D, Bauwens K, Sehouli J et al (2005) Emergency ultrasound-based algorithms for diagnosing blunt abdominal trauma. Cochrane Database Syst Rev 18(2):CD004446

    Google Scholar 

  35. Catalano O, Cusati B, Nunziata A, Siani A (2006) Active abdominal bleeding: contrast-enhanced sonography. Abdom Imaging 31(1):9–16

    Article  CAS  PubMed  Google Scholar 

  36. Stoker J, Randen A van, Laméris W, Boermeester MA (2009) Imaging patients with acute abdominal pain. Radiology 253(1):31–46

    Article  PubMed  Google Scholar 

  37. Earls JP, Dachman AH, Colon E et al (1993) Prevalence and duration of postoperative pneumoperitoneum: sensitivity of CT vs left lateral decubitus radiography. AJR Am J Roentgenol 161(4):781–785

    CAS  PubMed  Google Scholar 

  38. Ng CS, Watson CJ, Palmer CR et al (2002) Evaluation of early abdominopelvic computed tomography in patients with acute abdominal pain of unknown cause: prospective randomised study. BMJ 325(7377):1387

    Article  PubMed  Google Scholar 

  39. Rosen MP, Siewert B, Sands DZ et al (2003) Value of abdominal CT in the emergency department for patients with abdominal pain. Eur Radiol 13(2):418–424

    PubMed  Google Scholar 

  40. Leschka S, Alkadhi H, Wildermuth S, Marincek B (2005) Multi-detector computed tomography of acute abdomen. Eur Radiol 15(12):2435–2447

    Article  PubMed  Google Scholar 

  41. Birchard KR, Brown MA, Hyslop WB et al (2005) MRI of acute abdominal and pelvic pain in pregnant patients. AJR Am J Roentgenol 184(2):452–458

    PubMed  Google Scholar 

  42. Antonopoulos P, Constantinidis F, Charalampopoulos G et al (2008) An emergency diagnostic dilemma: a case of Yersinia enterocolitica colitis mimicking acute appendicitis in a beta-thalassemia major patient: the role of CT and literature review. Emerg Radiol 15(2):123–126

    Article  PubMed  Google Scholar 

  43. Attard AR, Corlett MJ, Kidner NJ (1992) Safety of early pain relief for acute abdominal pain. BMJ 305:556–561

    Article  Google Scholar 

  44. Helfand M, Freeman M (2009) Assessment and management of acute pain in adult medical inpatients: a systematic review. Pain Med 10(7):1183–1199

    Article  PubMed  Google Scholar 

  45. Tait IS, Ionescu MV, Cuschieri A (1999) Do patients with acute abdominal pain wait unduly long for analgesia? J R Coll Surg Edinb 44:181–184

    CAS  PubMed  Google Scholar 

  46. Panchal SJ, Müller-Schwefe P, Wurzelmann JI (2007) Opioid-induced bowel dysfunction: prevalence, pathophysiology and burden. Int J Clin Pract 61(7):1181–1187

    Article  CAS  PubMed  Google Scholar 

  47. Feu F, Ruiz del Arbol L, Bañares R et al (1996) Double-blind randomized controlled trial comparing terlipressin and somatostatin for acute variceal hemorrhage. Variceal bleeding study group. Gastroenterology 111(5):1291–1299

    Article  CAS  PubMed  Google Scholar 

  48. Levacher S, Letoumelin P, Pateron D et al (1995) Early administration of terlipressin plus glyceryl trinitrate to control active upper gastrointestinal bleeding in cirrhotic patients. Lancet 346:865–868

    Article  CAS  PubMed  Google Scholar 

  49. Gøtzsche PC, Hróbjartsson A (2008) Somatostatin analogues for acute bleeding oesophageal varices. Cochrane Database Syst Rev 16(3):CD000193

    Google Scholar 

  50. Ammaturo C, De Rosa A, Salzano A et al (2001) Intestinal infarction: report of 98 cases. Chir Ital 53(1):57–64

    CAS  PubMed  Google Scholar 

  51. Maerz L, Kaplan LJ (2008) Abdominal compartment syndrome. Crit Care Med 36(4 Suppl):S212–S215

    Article  PubMed  Google Scholar 

  52. Holstege A, Lock G, Reng M et al (1997) Akuter Bauchschmerz als Notfallsituation. Notfallmedizin 23:81–89

    Google Scholar 

  53. Reng M, Lock G, Messmann H et al (1998) Präklinische Notfallmedizin. Internist 39:161–170

    Article  CAS  PubMed  Google Scholar 

  54. Smith JE, Hall EJ (2009) The use of plain abdominal x rays in the emergency department. Emerg Med J 26:160–163

    Article  CAS  PubMed  Google Scholar 

Download references

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

  1. Gastroenterologie, Intensivmedizin, Notfallmedizin, Klinik Bogen, Mussinanstr. 8, 94327, Bogen, Deutschland

    C.-M. Reng

  2. Medizinische Klinik II, Krankenhaus Hetzelstift, Neustadt an der Weinstraße, Deutschland

    S. Grüne

Authors
  1. C.-M. Reng
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Grüne
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C.-M. Reng.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Reng, CM., Grüne, S. Akutes Abdomen. Intensivmed 47, 225–234 (2010). https://doi.org/10.1007/s00390-009-0160-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00390-009-0160-y

Schlüsselwörter

Keywords

Search

Navigation