Akutes Abdomen pp 339-352 | Cite as

Pankreas

Zusammenfassung

Akute gürtelförmige Oberbauchschmerzen verbunden mit einer Erhöhung der Pankreasamylase über das Dreifache des Serumnormalwerts sind pathognomonisch für die akute Pankreatitis. Patienten mit chronischer Pankreatitis sind gekennzeichnet durch rezidivierende Entzündungsschübe und starke Schmerzen, die wie ein akutes Abdomen imponieren. Bei rein konservativer Therapie persistieren diese rezidivierenden Schmerzattacken teilweise bis zu 10 Jahre lang. Pankreasabszesse oder -pseudozysten treten vereinzelt nach konservativer Therapie einer akuten Pankreatitis metachron nach einigen Wochen auf. Der Patient präsentiert sich selten mit einem akuten Abdomen, vielmehr mit lokalem Druckschmerz und in persistierend körperlich reduziertem Allgemeinzustand. Zu den Tumoren des Pankreas werden sowohl benigne als auch maligne Entitäten gezählt, die von endokrinem oder exokrinem Gewebe ausgehen können. Die Diagnosestellung erfolgt häufig als Zufallsbefund; Schmerzen oder ein akutes Abdomen als Leitsymptom sind sehr selten und sprechen für einen lokal fortgeschrittenen Prozess.

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Copyright information

© Springer-Verlag Wien 2016

Authors and Affiliations

  1. 1.Klinik für Chirurgie; Campus LübeckUniversitätsklinikum Schleswig-HolsteinLübeckDeutschland
  2. 2.Klinik für ChirurgieUniversitätsklinikum S-H Campus LübeckLübeckDeutschland
  3. 3.Klinik für Allgemein- und ViszeralchirurgieUniversitätsklinikum FreiburgFreiburgDeutschland

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