Diagnostik und therapeutische Strategien beim Abdominal- und Lebertrauma haben sich stetig weiterentwickelt. Sonographie und Computertomographie sind diagnostisch und therapeutisch neben der Kreislaufstabilität wegweisend. Bei stabilen Situationen hat heute das konservative Vorgehen Priorität mit hoher Erfolgsrate. Nur beim instabilen Patienten oder Verletzungen Grad III und höher sind operative Vorgehensweisen erforderlich. Das Beherrschen des Packing mit Blutungskontrolle ist das primäre Therapieziel, das ggf. auch erst sekundär nach Verlegung durch gezielte interventionelle und operative Maßnahmen zur definitiven Versorgung ergänzt wird.
Therapeutic strategies for liver trauma.
Diagnostic as well as therapeutic strategies in abdominal and liver trauma have continuously been evolved further during the last three decades, Ultrasound and Ctscan are the cornerstones of decisions beside the clinical especially the cardiovascular situation. Non-operative Management is nowadays the standard procedure in stable conditions. Only in unstable patients and in grade III or higher graded injurys operative intervention is necessary as lifesaving procedure. Sufficient damage control by packing is the primary therapeutic goal. Definitive interventional or operative management may be achieved in an secondary approach even after patient referal.
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