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Acute abdomen. Akutes Abdomen. The book first presents the anatomy and physiology of the abdomen and continues with chapters discussing clinical and laboratory aspects and a suitable order of diagnostic examinations with reference to the acute processes, explaining the diagnostic tools: ultrasonography, radiography including angiography and CT, tapping techniques and endoscopy together with their basic principles, examination techniques, and diagnosis. One chapter presents a complete survey of the processes involving the entire abdomen - as e. This chapter profoundly discusses the diagnostics and therapies including emergency measures and surgery.

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Acute abdomen. Akutes Abdomen. The book first presents the anatomy and physiology of the abdomen and continues with chapters discussing clinical and laboratory aspects and a suitable order of diagnostic examinations with reference to the acute processes, explaining the diagnostic tools: ultrasonography, radiography including angiography and CT, tapping techniques and endoscopy together with their basic principles, examination techniques, and diagnosis.

One chapter presents a complete survey of the processes involving the entire abdomen - as e. This chapter profoundly discusses the diagnostics and therapies including emergency measures and surgery.

Problems requiring consultation among varous specialists, in internal medicine, gynecology, urology, or pediatrics, are discussed in great detail. Information for the anesthetist is given for cases of emergency. More than one third of the book is devoted to organ-specific information, dicussing the pathogenesis, diagnostics, and therapy of the oesophagus, stomach, large and small intestine, bile ducts, pankreas, liver, spleen, and the abdominal vessels and the abdominal wall.

With figs. Diagnostics of vascular diseases as a cause for acute abdomen ; Diagnostik vaskulaerer Erkrankungen als Ursache fuer das akute Abdomen.

Juchems, M. Vascular pathologies are rare causes of an acute abdomen. If the cause is a vascular disease a rapid diagnosis is desired as vascular pathologies are associated with high mortality. A differentiation must be made between arterial and venous diseases.

An occlusion of the superior mesenteric artery is the most common reason for acute mesenteric ischemia but intra-abdominal arterial bleeding is also of great importance. Venous pathologies include thrombotic occlusion of the portal vein, the mesenteric vein and the vena cava.

Multi-detector computed tomography MDCT is predestined for the diagnostics of vascular diseases of the abdomen. Using multiphasic contrast protocols enables reliable imaging of the arterial and venous vessel tree and detection of disorders with high sensitivity and specificity. Although conventional angiography has been almost completely replaced by MDCT as a diagnostic tool, it is still of high importance for minimally invasive interventions, for example in the management of gastrointestinal bleeding.

Liegt eine vaskulaere Erkrankung vor, ist jedoch aufgrund der hohen Mortalitaet eine zuegige Diagnostik von grosser Wichtigkeit. Bei den Erkrankungen der abdominellen Gefaesse sind arterielle von venoesen Ursachen zu unterscheiden. Ein Verschluss der A. Venoese Pathologien betreffen thrombotische Verschluesse der Pfortader, der V.

Mit mehrphasigen Untersuchungsprotokollen gelingt es, den arteriellen und venoesen Gefaessbaum zuverlaessig darzustellen und Erkrankungen mit hoher Sensitivitaet und Spezifitaet zu. Clinical background and demands on imaging; Akutes Abdomen. Klinische Begriffsbestimmung und Anforderungen an die Bildgebung.

Graeb, C. The term ''acute abdomen '' does not describe a specific disease entity but is more a critical clinical state which incorporates very heterogeneous clinical presentations. The prognosis of any disease depends on the time frame from the onset of symptoms to the initiation of a specific therapy.

For this reason there are special expectations by clinicians regarding the diagnostic assessment provided by radiology which is expected to deliver an immediate diagnosis supporting further therapeutic decisions. Along with the patient's clinical history, physical examination and blood tests, radiological diagnostics are essential for enabling a specific treatment. From a surgical point of view the radiologist is expected to help in differentiating between cases with indications for emergency surgery and cases eligible for elective surgery or conservative treatment.

Das Zeitintervall zwischen dem Auftreten der ersten Symptome bis zur Einleitung einer gezielten Therapie ist fuer die Prognose der Patienten der entscheidende Faktor.

Aus diesem Grund bestehen besondere Anforderungen an die bildgebende Diagnostik, die dazu beitragen soll, innerhalb kuerzester Zeit eine moeglichst genaue Diagnose zu stellen. Neben Anamnese, klinischer Untersuchung und Labordiagnostik stellt die radiologische Untersuchung einen wesentlichen Baustein vor der Therapieeinleitung dar.

Aus chirurgischer Sicht muessen Krankheitsbilder, die eine sofortige Notfalloperation erforderlich machen, von Erkrankungen differenziert werden, die eine elektive Chirurgie oder ein konservatives Vorgehen indizieren. Differential diagnosis of the acute abdomen. Acute abdomen in children; Differenzialdiagnose des akuten Abdomens. Akutes Abdomen im Kindesalter. Staatz, Gundula [Universitaetsklinikum Mainz Germany.

Muenchen Germany. The diagnostic work-up of adults with acute abdominal pain has changed significantly within the last decade and computed tomography is often used as the first imaging modality of choice.

In pediatric patients with an acute abdomen , ultrasound and abdominal X-rays remain the first line procedures. Because of the radiation risk, computed tomography is only recommended in selected cases and when strongly indicated.

This review is the fourth and final part within a series of reviews dealing with the diagnostic strategy in the work-up of patients with an acute abdomen. CT findings in acute small bowel diverticulitis; Computertomographie bei akuter Duenndarmdivertikulitis. Ferstl, F. Theresienkrankenhaus Nuernberg Germany.

Small bowel diverticulitis is a rare cause of an acute abdomen. Originating from acquired diverticula of the jejunum, less often of the ileum, or Meckel diverticulum, the symptoms are non-specific, simulating other acute inflammatory disorders, such as appendicitis, cholecystitis or colonic diverticulitis. The diagnosis of small bowel diverticulitis is solely based on radiologic findings, with computed tomography CT regarded as the method of choice.

In recent years, a number of case reports have described the spectrum of the CT features in acute small bowel diverticulitis and its dependence on the severity of the inflammatory process. Typical findings are an inflamed diverticulum, inflammatory mesenteric infiltration, extraluminal gas collection and mural edema of adjacent small bowel loops with resultant separation of bowel loops.

An enterolith is rarely found in an inflamed diverticulum. Complications include abscesses, fistulae, small bowel obstruction and free perforation with peritonitis. Small bowel diverticulitis can be a diagnostic problem if it involves the terminal ileum or Meckel's diverticulum. For preoperative confirmation of the presumed diagnosis of small bowel diverticulitis on CT, an enteroclysis for acquired diverticula or a technetium scan for Meckel's diverticulum should be performed.

We present the CT findings in three patients of acute small bowel diverticulitis, two affecting the jejunum and one a Meckel's diverticulum. Ausgehend von den erworbenen Divertikeln des Jejunums, seltener des Ileums, oder von einem Meckel-Divertikel, manifestiert sich die Divertikulitis klinisch durch eine unspezifische Symptomatik, die zuerst an die haeufigeren, akutentzuendlichen Erkrankungen des Abdomens wie z.

Appendizitis, Cholezystitis oder Kolondivertikulitis denken laesst. Die Duenndarmdivertikulitis kann praeoperativ nur durch. Acute disseminated encephalomyelitis; Akute disseminierte Enzephalomyelitis. Politi, M. Acute disseminated encephalomyelitis ADEM is an acute widespread autoimmune demyelinating condition, which principally affects the white matter of the brain and spinal cord.

It usually follows an infection or vaccination. The typical presentation is that of multifocal neurologic disturbances accompanied by change in mental status. CSF analysis reveals lymphocytic pleocytosis and elevated protein content, but may also yield normal results. MRI is regarded as the diagnostic imaging modality of choice and typically demonstrates involvement of deep cerebral hemispheric and subcortical white matter as well as lesions in the basal ganglia, gray-white junction, diencephalon, brainstem, cerebellum and spinal cord.

Ueblicherweise tritt sie nach einer Infektion oder Impfung auf. Lymphozytaere Pleozytose und Eiweisserhoehung sind typische Befunde in der Liquoruntersuchung. Sie koennen in den Gross- und Kleinhirnhemisphaeren, im Hirnstamm und im Rueckenmark lokalisiert sein. Die subkortikale und die zentrale weisse Substanz sind am haeufigsten befallen.

Weniger haeufig ist die graue Substanz der Thalami und der Basalganglien betroffen. If there is an occurrence of peritonitis as a complication of jejunal diverticulitis, laparatomy may be indicated. Both of the patients received a conservative treatment with intravenous fluids and antibiotics with good response The abdomen. Radiographic evaluation of the abdomen is obtained less often than that of the chest with the postoperative or critically ill patient. Because of the limitations in mobility with these patients, the studies are usually made with a portable radiographic unit and often require considerable assistance from the intensive care unit ICU staff.

The technologist must use considerable care in obtaining these studies; optimal radiographic technique and careful patient positioning should result in a satisfactory radiograph so that the study will not have to be repeated. If a ''supine abdomen '' film is requested, the technologist will center the film to include the diaphragm; with a ''kidney-ureter-bladder'' film, the pelvis will be included and the diaphragm may not be seen.

It is important to have as much clinical information as possible before interpreting any radiographs of the critically ill patient. Directory of Open Access Journals Sweden. Full Text Available cases of acute abdomen have been analysed in detail includ-ing their clinical presentation and operative findings. Males are more frequently affected than females in a ratio of 3: 1. Intestinal obstruction was the commonest cause of acute abdomen Perforated peptic ulcer was the commonest cause of peritonitis in the present series Pasien mengalamihenti jantung dan udem paru akut yang merupakan gagal jantung akut.

Pasien memerlukanpenatalaksanaan multidisiplin dan intensif. Pada pasien diberikan dukungan ventilasi mekanik dengan tekanan positifyaitu CPAP untuk mengurangi mortalitas edema paru.

Selain itu diperlukan pemantauan ketat hemodinamik danasupan nutrisi pada pasien. Selain masalah jantung dan paru, pada pasien juga terjadi penurunan kesadaran setalahhenti jantung. Gangguan pada sistem saraf pusat merupakan penyebab kematian yang cukup tinggi pada pasien yangselamat dari henti jantung dan resusitasi.

Berdasarkan hal itu, perlu dilakukan resusitasi kardioserebral pada pasiendengan henti jantung. Perbedaan utama dengan resusitasi jantung paru adalah pentingnya manajemen j alan nafasyang lebih lengkap dengan ventilasi mekanik. The patient had a cardiac arrest and acutepulmonary edema is acute heart failure.

Cardiac arrest in this patient initiated by malignant arrhythmias caused by lackof oxygen to the heart muscle. Patients require multidisciplinary and intensive management. In patients receivedmechanical ventilatory support with positive pressure that CPAP to reduce the mortality of pulmonary edema. Acute abdomen is not a disease in itself but a description of a complex of symptoms combined with severe abdominal pain developed within a time frame of less than 24 h.

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