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Gastroenterologie up2date 2016; 12(02): 163-177
DOI: 10.1055/s-0042-107525
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© Georg Thieme Verlag KG Stuttgart · New York

Differenzialdiagnostik und -therapie des akuten Abdomens

Lena Seifert
,
Jürgen Weitz
,
Marius Distler
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Publication History

Publication Date:
21 June 2016 (online)

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Kernaussagen

Klinik und Diagnostik

  • Bei akutem Abdomen ist eine akute Abklärung des Befundes notwendig.

  • Ein Allgemein- und Viszeralchirurg sollte frühzeitig mit einbezogen werden.

  • Neben dem Leitsymptom Bauchschmerz können weitere Begleitsymptome (Motilitätsstörung, Erbrechen, Stuhlverhalt, Schock) auftreten.

  • Die detaillierte Anamnese (Schmerz-, abdominelle und allgemeine Anamnese) und die klinische Untersuchung (Inspektion, Auskultation, Perkussion, Palpation und digital-rektale Untersuchung) sind richtungsweisend bei der Diagnosestellung.

  • Eine Basisdiagnostik aus Labor und Sonografie sollte bei jedem Patienten durchgeführt werden.

  • Jede weiterführende Diagnostik sollte zielgerichtet sein.

Therapie

  • Je dringlicher die Indikation zur Behandlung, desto weniger Diagnostik sollte durchgeführt werden.

  • Die Indikation zur chirurgischen Therapie wird durch den beteiligten Chirurgen gestellt.

  • Insbesondere bei unbekanntem Fokus des akuten Abdomens ist der Standardzugang eine mediane Längslaparotomie.

 

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