Zusammenfassung
Trotz der Limitationen, insbesondere dass Ultraschall lufthaltige Lunge nicht durchdringen
kann, ist die Thoraxsonografie eine wichtige diagnostische Methode. Die Möglichkeit
des Point-of-Care-Einsatzes und die fehlende Strahlenexposition sind dabei definitive
Vorteile. Dieser Artikel soll einen ersten Eindruck vermitteln, wie man am besten
wo schallt und was sonomorphologisch zu erwarten ist. Orientiert an Leitsymptomen
wie Dyspnoe mit und ohne Fieber und Thoraxschmerzen mit und ohne Trauma werden die
wichtigsten Pathologien für die Notfallsituation beschrieben.
Abstract
Despite the limitations (especially that ultrasound does not penetrate air containing
lung tissue) ultrasound of the thorax is a very suitable method as a complementary
or even primary diagnostic tool. Bedside availability and no radiation exposure are
real advantages. However we always have to keep in mind that we are blind for deeper
lung processes that do not have contact to the visceral pleura.
This article illustrates where and how to look for pathologies and what we have to
expect in patients. According to symptoms such as dyspnea, dyspnea with fever and
thorax pain with and without trauma, the sonographic morphology of important illnesses
in emergency situation are described. The use of ultrasound can help to distinguish
between differential diagnosis such as acute exacerbation of COPD vs. heart failure,
pleuritis vs. pulmonary embolism, rip fracture vs. “simple” bone contusion and blunt
chest trauma with or without pneumothorax.
Schlüsselwörter
Notfallsonografie - Thorax - Pneumothorax
Keywords
Emergency ultrasound - thorax - pneumothorax
