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Perforiertes Magenulkus als kausale Ursache einer unklaren Bewusstlosigkeit?

Koinzidenz eines septischen Schocks und eines Apoplex

Perforated gastric ulcer as cause of an unclear coma?

Coincidence of septic shock and stroke

  • Kasuistiken
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Zusammenfassung

Hintergrund

Die schwere Sepsis bzw. der septische Schock sind lebensbedrohliche, zeitkritische Notfälle. Trotz Fortschritten in der Intensivmedizin haben sie immer noch eine hohe Letalität. Voraussetzungen für eine erfolgreiche Behandlung sind eine zügige Diagnosestellung und unverzügliche kausale Therapie.

Ziel

Welche differenzialdiagnostischen Schwierigkeiten sich für den behandelnden Notarzt ergeben können, wird anhand der Kasuistik eines 50-jährigen komatösen Patienten im protrahierten septischen Schock deutlich. Der komplikationsträchtige Verlauf sowie diagnostische und therapeutische Maßnahmen werden kritisch diskutiert.

Abstract

Background

Severe sepsis and septic shock are life-threatening, time-critical emergency situations. In spite of advances in critical care medicine the mortality is still high. A rapid diagnostic routine and an immediate causal treatment are preconditions for successful medical treatment.

Objective

The differential diagnostic problems confronted by emergency physicians and emergency medical technicians are presented exemplified by the case report of a 50-year-old comatose patient in a state of prolonged septic shock. The complicated course of convalescence and therapeutic procedures are critically discussed.

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Literatur

  1. Deakin CD, Nolan JP, Soar J et al (2010) European Resuscitation Council Guidelines for Resuscitation 2010 Section 4. Adult advanced life support. Resuscitation 81:1305–1352

    Article  PubMed  Google Scholar 

  2. Dellinger RP, Levy MM, Carlet JM et al (2008) Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008. Intensive Care Med 34:17–60

    Article  PubMed  Google Scholar 

  3. Fries M, Stoppe C, Brucken D et al (2009) Influence of mild therapeutic hypothermia on the inflammatory response after successful resuscitation from cardiac arrest. J Crit Care 24:453–457

    Article  PubMed  Google Scholar 

  4. Levy MM, Dellinger RP, Townsend SR et al (2010) The Surviving Sepsis Campaign: results of an international guideline-based performance improvement program targeting severe sepsis. Crit Care Med 38:367–374

    Article  PubMed  Google Scholar 

  5. Reinhart K, Brunkhorst FM, Bone HG et al (2010) Prevention, diagnosis, therapy and follow-up care of sepsis: 1st revision of S-2k guidelines of the German Sepsis Society (Deutsche Sepsis-Gesellschaft e. V. (DSG)) and the German Interdisciplinary Association of Intensive Care and Emergency Medicine (Deutsche Interdisziplinare Vereinigung fur Intensiv- und Notfallmedizin (DIVI)). German medical science: GMS e-journal 8:Doc14

  6. Torossian A, Ruehlmann S, Middeke M et al (2004) Mild preseptic hypothermia is detrimental in rats. Crit Care Med 32:1899–1903

    Article  PubMed  Google Scholar 

  7. Wang HE, Shapiro NI, Angus DC et al (2007) National estimates of severe sepsis in United States emergency departments. Crit Care Med 35:1928–1936

    Article  PubMed  Google Scholar 

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Compliance with Ethics Guidelines

 

Conflict of Interest

A. Lugeder, D. Klüppel, I. Barndt, A. Baderkhan, and J. Zeichen declare that they have no conflict of interest.

 

This article does not contain any studies with human or animal subjects.

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Authors and Affiliations

  1. Klinik für Unfallchirurgie und Orthopädie, Johannes Wesling Klinikum Minden, Hans-Nolte-Straße 1, 32429, Minden, Deutschland

    A. Lugeder & J. Zeichen

  2. Zentrum für Innere Medizin – Schwerpunkt Kardiologie und Internistische Intensivmedizin, Johannes Wesling Klinikum Minden, Minden, Deutschland

    I. Barndt

  3. Klinik für Allgemeinchirurgie, Visceral-, Thorax- und Gefäßchirurgie, Johannes Wesling Klinikum Minden, Minden, Deutschland

    A. Baderkhan

  4. Institut für Anästhesiologie, Johannes Wesling Klinikum Minden, Minden, Deutschland

    D. Klüppel

  5. Intensivmedizinisches Zentrum, Johannes Wesling Klinikum Minden, Minden, Deutschland

    D. Klüppel & J. Zeichen

  6. Notarztdienst am Johannes Wesling Klinikum Minden, Minden, Deutschland

    A. Lugeder & D. Klüppel

Authors
  1. A. Lugeder
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  2. D. Klüppel
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  3. I. Barndt
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  4. A. Baderkhan
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  5. J. Zeichen
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Corresponding author

Correspondence to A. Lugeder.

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Lugeder, A., Klüppel, D., Barndt, I. et al. Perforiertes Magenulkus als kausale Ursache einer unklaren Bewusstlosigkeit?. Notfall Rettungsmed 16, 543–548 (2013). https://doi.org/10.1007/s10049-013-1742-6

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  • DOI: https://doi.org/10.1007/s10049-013-1742-6

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