Kinderchirurgische Notfälle – was in der Akutsituation wichtig ist

Kinderchirurgische Notfälle, d. h. akute Erkrankungen, die in der Regel eine Operation erfordern, können nahezu alle Organsysteme betreffen. Neben den unfallbedingten Verletzungen ist das akute Abdomen einer der häufigsten Gründe einer Notfallversorgung. In diesem Beitrag werden vor allem viszeralchirurgische Notfälle bei Kindern besprochen, der besondere Schwerpunkt liegt auf den Aspekten der präklinischen Versorgung.

Schlüsselwörter

akutes Abdomen - Volvulus - galliges Erbrechen - stumpfes Bauchtrauma - Pädiatrie

• Literatur

• 1 Scholer SJ, Pituch K, Orr DP. et al. Clinical outcomes of children with acute abdominal pain. Pediatrics 1996; 98: 680-685
• 2 van der Sluijs R, Debray TPA, Poeze M. et al. Development and validation of a novel prediction model to identify patients in need of specialized trauma care during field triage: design and rationale of the GOAT study. Diagn Progn Res 2019; 3: 12 doi:10.1186/s41512-019-0058-5
• 3 Sharwood LN, Babl FE. The efficacy and effect of opioid analgesia in undifferentiated abdominal pain in children: a review of four studies. Paediatr Anaesth 2009; 19: 445-451 doi:10.1111/j.1460-9592.2008.02807.x
• 4 Gaines BA. Intra-abdominal solid organ injury in children: diagnosis and treatment. J Trauma 2009; 67: S135-S139 doi:10.1097/TA.0b013e3181adc17a
• 5 Müller-Lobeck L, Birnbaum J, Spies C. Kindernotfälle – Allgemeine Behandlungsstrategien. Anesthesiol Intensivmed Notfallmed Schmerzther 2009; 44: 422-428
• 6 Newgard CD. Defining the “older” crash victim: the relationship between age and serious injury in motor vehicle crashes. Accid Anal Prev 2008; 40: 1498-1505 doi:10.1016/j.aap.2008.03.010
• 7 Englum BR, Rialon KL, Kim J. et al. Current use and outcomes of helicopter transport in pediatric trauma: a review of 18,291 transports. J Pediatr Surg 2017; 52: 140-144 doi:10.1016/j.jpedsurg.2016.10.030
• 8 Nance ML, Holmes 4th JH, Wiebe DJ. Timeline to operative intervention for solid organ injuries in children. J Trauma 2006; 61: 1389-1392 doi:10.1097/01.ta.0000244167.45002.58
• 9 Adelgais KM, Kuppermann N, Kooistra J. et al. Accuracy of the abdominal examination for identifying children with blunt intra-abdominal injuries. J Pediatr 2014; 165: 1230-1235.e5 doi:10.1016/j.jpeds.2014.08.014
• 10 Drucker NA, McDuffie L, Groh E. et al. Physical examination is the best predictor of the need for abdominal surgery in children following motor vehicle collision. J Emerg Med 2018; 54: 1-7 doi:10.1016/j.jemermed.2017.08.008
• 11 Holmes JF, Lillis K, Monroe D. et al. Identifying children at very low risk of clinically important blunt abdominal injuries. Ann Emerg Med 2013; 62: 107-116.e2 doi:10.1016/j.annemergmed.2012.11.009
• 12 Borgialli DA, Ellison AM, Ehrlich P. et al. Association between the seat belt sign and intra-abdominal injuries in children with blunt torso trauma in motor vehicle collisions. Acad Emerg Med 2014; 21: 1240-1248 doi:10.1111/acem.12506
• 13 Saladino R, Lund D, Fleisher G. The spectrum of liver and spleen injuries in children: failure of the pediatric trauma score and clinical signs to predict isolated injuries. Ann Emerg Med 1991; 20: 636-640
• 14 Langer JC. Intestinal Rotation Abnormalities and Midgut Volvulus. Surg Clin North Am 2017; 97: 147-159 doi:10.1016/j.suc.2016.08.011
• 15 Millar AJ, Rode H, Cywes S. Malrotation and volvulus in infancy and childhood. Semin Pediatr Surg 2003; 12: 229-236
• 16 Fiegel H, Gfroerer S, Rolle U. Systematic review shows that pathological lead points are important and frequent in intussusception and are not limited to infants. Acta Paediatr 2016; 105: 1275-1279 doi:10.1111/apa.13567
• 17 Bogdanovic M, Blagojevic M, Kuzmanovic J. et al. Fatal intussusception in infancy: forensic implications. Forensic Sci Med Pathol 2019; 15: 284-287 doi:10.1007/s12024-018-0039-y