Tamandl D, Uray T
Universitätsklinik für Radiologie und Nuklearmedizin, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich.
Universitätsklinik für Notfallmedizin, Medizinische Universität Wien, Währinger Gürtel 18-20, Wien, Österreich.
Radiologe. 2019 Feb;59(2):95-105. doi: 10.1007/s00117-018-0484-3.
Acute abdominal pain is a prevalent problem in the emergency department. The work-up has to include a broad spectrum of differential diagnoses, which should be narrowed down with respect to frequent diagnoses without overlooking rare but potentially even more severe pathologies.
The radiological method of choice for the initial work-up after sonography is computed tomography, which has demonstrated the highest sensitivity and specificity for most findings. Plain film radiographs of the abdomen rarely contribute to the final diagnosis. Magnetic resonance imaging is reserved for selected cases, which are described in this article.
The clinical decision trees and recommendations, which need to be in the report depending on the diagnosis, are of relevance for every radiologist who deals with patients with acute abdominal presentations.
Knowledge of the clinical diagnostic approach in patients with acute abdomen is an unavoidable prerequisite for optimal cooperation between clinicians and radiologists in acute situations.
急性腹痛是急诊科常见的问题。检查必须涵盖广泛的鉴别诊断范围,应针对常见诊断缩小范围,同时不能忽视罕见但可能更严重的病症。
超声检查后进行初步检查的首选放射学方法是计算机断层扫描,它对大多数检查结果显示出最高的敏感性和特异性。腹部平片对最终诊断的作用很小。磁共振成像适用于本文所述的特定病例。
根据诊断情况在报告中给出的临床决策树和建议,对处理急性腹部症状患者的每位放射科医生都具有重要意义。
了解急腹症患者的临床诊断方法是临床医生和放射科医生在紧急情况下实现最佳协作不可避免的前提条件。