{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T15:21:09Z","timestamp":1784128869438,"version":"3.55.0"},"reference-count":39,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Zentralbl Chir"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Die h\u00e4ufigsten betroffenen Organe abdomineller Traumata sind die Milz und die Leber, h\u00e4ufig auch in Kombination. Verletzungen des Pankreas sind vergleichsweise selten. Beim deutlich h\u00e4ufigeren stumpfen Abdominaltrauma sollte nach Einsch\u00e4tzung der Kreislaufsituation eine klinische und laborchemische Untersuchung sowie eine Sonografie durchgef\u00fchrt werden. Sofern eine h\u00e4modynamische Instabilit\u00e4t und freie Fl\u00fcssigkeit vorliegen, ergibt sich die Indikation zur notfallm\u00e4\u00dfigen Laparotomie. Bei stabiler bzw. stabilisierbarer Situation und auff\u00e4lliger Sonografie sowie obligat beim polytraumatisierten Patienten ist die Durchf\u00fchrung einer triphasischen Kontrastmittel-Computertomografie unabdingbar. Bei Verdacht auf eine renale Verletzung sollte eine sp\u00e4tven\u00f6se urografische Phase angeschlossen werden. Neben der dadurch m\u00f6glichen Klassifizierung der Verletzung ist auf eine m\u00f6gliche Gef\u00e4\u00dfbeteiligung oder akute Blutung zu achten. Sollte Letzteres vorliegen, ist eine Angiografie mit\n          Interventionsm\u00f6glichkeit anzustreben. Bei Verletzungen des Ductus pancreaticus ist eine endoskopische Behandlung m\u00f6glich. Sollte sich in der Bildgebung kein Interventionsziel demaskieren und eine stabile Kreislaufsituation vorherrschen, ist ein rein konservatives Vorgehen unter kontinuierlicher Monitor\u00fcberwachung mittels klinischer, laborchemischer und sonografischer Kontrollen m\u00f6glich. Die meisten Verletzungen k\u00f6nnen erfolgreich konservativ (nicht operatives Management [NOM]) behandelt werden.<\/jats:p><jats:p>Das operative Verfahren ergibt sich aus dem Verletzungsmuster und reicht von der lokalen Blutstillung bis zur Organresektion. Ebenso besteht die Option der \u201eDamage Control Surgery\u201c mit akuter Blutungskontrolle und zweizeitiger Versorgung. Komplexe chirurgische Eingriffe sollten an Zentren durchgef\u00fchrt werden. Postoperative Komplikationen ergeben sich analog der elektiven Chirurgie.<\/jats:p><jats:p>Beim selteneren penetrierenden Bauchtrauma kann das tats\u00e4chliche Verletzungsausma\u00df nicht durch die \u00e4u\u00dferlich sichtbare Wunde eingesch\u00e4tzt werden. Auch hier ist prim\u00e4r die Kreislaufsituation entscheidend und bei Instabilit\u00e4t eine Notfalllaparotomie durchzuf\u00fchren. Bei Stabilit\u00e4t sollte eine weitere Diagnostik mittels Kontrastmittel-Computertomografie erfolgen. Bei nicht klar auszuschlie\u00dfender Penetration des Peritoneums ist eine diagnostische Laparoskopie indiziert.<\/jats:p>","DOI":"10.1055\/a-2301-7951","type":"journal-article","created":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T23:00:43Z","timestamp":1714431643000},"page":"359-367","source":"Crossref","is-referenced-by-count":3,"title":["Management von Verletzungen parenchymat\u00f6ser Abdominalorgane"],"prefix":"10.1055","volume":"149","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-6597-7354","authenticated-orcid":false,"given":"Stina","family":"Schild-Suhren","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Allgemein-, Viszeral- und Kinderchirurgie, Universit\u00e4tsmedizin G\u00f6ttingen, Gottingen, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elif","family":"Yilmaz","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Allgemein-, Viszeral- und Kinderchirurgie, Universit\u00e4tsmedizin G\u00f6ttingen, 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