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DOI: 10.1055/a-2326-2786
SOP Leitsymptom Flankenschmerzen
SOP Leading symptom: flank painHinter dem häufigen Leitsymptom Flankenschmerzen kann sich – neben Auslösern wie Harnleitersteinen oder Pyelonephritiden – eine ganze Reihe unterschiedlicher Krankheitsbilder verbergen. Diese SOP soll Ärztinnen und Ärzten in der Notaufnahme eine Übersicht über die möglichen Ursachen geben. Ausgehend von Anamnese, Untersuchung einschließlich Sonografie und Labordiagnostik werden wichtige Differenzialdiagnosen angesprochen sowie ein Algorithmus zur Bildgebung vorgestellt.
Abstract
In addition to triggers such as ureteral stones or pyelonephritis, the common symptom of flank pain can be associated with a whole range of conditions. This SOP is intended to give doctors in the emergency department an overview of the possible causes. Based on medical history, clincal examination including sonography and laboratory diagnostics, important differential diagnoses are addressed and an imaging algorithm is presented.
Publication History
Article published online:
01 July 2024
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Literatur
- 1 Kamin RA, Nowicki TA, Courtney DS. et al. Pearls and pitfalls in the emergency department evaluation of abdominal pain. Emerg Med Clin North Am 2003; 21: 61-72 DOI: 10.1016/s0733-8627(02)00080-9. (PMID: 12630731)
- 2 Morley EJ, Bracey A, Reiter M. et al. Association of Pain Location With Computed Tomography Abnormalities in Emergeny Department Patients With Abdominal Pain. J Emerg Med 2020; 59: 485-490 DOI: 10.1016/j.jemermed.2020.06.002.
- 3 Staniland JR, Ditchburn J, De Dombal FT. Clinical presentation of acute abdomen: study of 600 patients. Br Med J 1972; 3: 393-398 DOI: 10.1136/bmj.3.5823.393. (PMID: 4506871)
- 4 Lax Y, Singh A. Referred Abdominal Pain. Pediatr Rev 2020; 41: 430-433 DOI: 10.1542/pir.2019-0221. (PMID: 32737258)
- 5 Tamm EP, Silverman PM, Shuman WP. Evaluation of the patient with flank pain and possible ureteral calculus. Radiology 2003; 228: 319-329 DOI: 10.1148/radiol.2282011726. (PMID: 12819343)
- 6 Heidenreich A, Desgrandschamps F, Terrier F. Modern approach of diagnosis and management of acute flank pain: review of all imaging modalities. Eur Urol 2002; 41: 351-362 DOI: 10.1016/s0302-2838(02)00064-7. (PMID: 12074804)
- 7 Hyams ES, Korley FK, Pham JC. et al. Trends in imaging use during the emergency department evaluation of flank pain. J Urol 2011; 186: 2270-2274 DOI: 10.1016/j.juro.2011.07.079.
- 8 Teichman JMH. Clinical practice. Acute renal colic from ureteral calculus. N Engl J Med 2004; 350: 684-693 DOI: 10.1056/NEJMcp030813. (PMID: 14960744)
- 9 Seitz C, Bach T, Bader M. et al. Aktualisierung der S2k-Leitlinie zur Diagnostik, Therapie und Metaphylaxe der Urolithiasis (AWMF Registernummer 043–025): Was ist neu?. Urologe A 2019; 58: 1304-1312 DOI: 10.1007/s00120-019-01033-7.
- 10 Mettler FA, Huda W, Yoshizumi TT. et al. Effective doses in radiology and diagnostic nuclear medicine: a catalog. Radiology 2008; 248: 254-263 DOI: 10.1148/radiol.2481071451. (PMID: 18566177)
- 11 Smith RC, Levine J, Dalrymple NC. et al. Acute flank pain: a modern approach to diagnosis and management. Semin Ultrasound CT MR 1999; 20: 108-135 DOI: 10.1016/s0887-2171(99)90042-2. (PMID: 10222519)
- 12 Wong C, Teitge B, Ross M. et al. The Accuracy and Prognostic Value of Point-of-care Ultrasound for Nephrolithiasis in the Emergency Department: A Systematic Review and Meta-analysis. Acad Emerg Med 2018; 25: 684-698 DOI: 10.1111/acem.13388. (PMID: 29427476)
- 13 Goerg C, Schwerk WB. Splenic infarction: sonographic patterns, diagnosis, follow-up, and complications. Radiology 1990; 174: 803-807 DOI: 10.1148/radiology.174.3.2406785. (PMID: 2406785)
- 14 Scruggs W, Fox JC, Potts B. et al. Accuracy of ED Bedside Ultrasound for Identification of gallstones: retrospective analysis of 575 studies. West J Emerg Med 2008; 9: 1-5 (PMID: 19561694)
- 15 Gallaher JR, Charles A. Acute Cholecystitis: A Review. JAMA 2022; 327: 965-975 DOI: 10.1001/jama.2022.2350. (PMID: 35258527)
- 16 Rhea JT, DeLuca SA, Toombs BD. Evaluation of a sequence of diagnostic tests using the workup of ureteral stone as a model. Med Care 1982; 20: 843-848 DOI: 10.1097/00005650-198208000-00008. (PMID: 7109753)
- 17 Moore CL, Bomann S, Daniels B. et al. Derivation and validation of a clinical prediction rule for uncomplicated ureteral stone – the STONE score: retrospective and prospective observational cohort studies. BMJ 2014; 348: g2191 DOI: 10.1136/bmj.g2191. (PMID: 24671981)
- 18 Bove P, Kaplan D, Dalrymple N. et al. Reexamining the value of hematuria testing in patients with acute flank pain. J Urol 1999; 162: 685-687 DOI: 10.1097/00005392-199909010-00013.
- 19 Luchs JS, Katz DS, Lane MJ. et al. Utility of hematuria testing in patients with suspected renal colic: correlation with unenhanced helical CT results. Urology 2002; 59: 839-842 DOI: 10.1016/s0090-4295(02)01558-3.
- 20 Kobayashi T, Nishizawa K, Mitsumori K. et al. Impact of date of onset on the absence of hematuria in patients with acute renal colic. J Urol 2003; 170: 1093-1096 DOI: 10.1097/01.ju.0000080709.11253.08.
- 21 Press SM, Smith AD. Incidence of negative hematuria in patients with acute urinary lithiasis presenting to the emergency room with flank pain. Urology 1995; 45: 753-757 DOI: 10.1016/S0090-4295(99)80078-8.