Skip to main content
SpringerLink
Log in

Gefäßverletzungen im Thorax, Abdomen und Becken

Thoracic, abdominal, and pelvic vascular injuries

  • Weiterbildung•Zertifizierte Fortbildung
  • Published:
Der Chirurg Aims and scope Submit manuscript

Zusammenfassung

Diese Arbeit soll einen Überblick über das chirurgische Management von Gefäßverletzungen geben. Neben der klinischen und sonographischen Basisdiagnostik liefert beim hämodynamisch stabilen Patienten vor allem die Computertomographie (CT) und in besonderen Fällen die Angiographie entscheidende Hilfen zu Differenzialdiagnosen. Die Angiographie ist in der Akutphase vor allem zur Therapieplanung und Durchführung interventioneller Eingriffe notwendig. Für die erfolgreiche Therapie von Gefäßverletzungen ist die schnelle Exposition und Blutungskontrolle eine wesentliche Voraussetzung.

Abstract

This paper reviews the surgical management of vascular injuries. Precise clinical and ultrasound evaluation is mandatory during the first steps of emergency treatment. For further documentation of the extent and site of arterial injuries in hemodynamically stable patients, computed tomography and angiography are crucial in differential diagnosis. Especially during the acute phase, the latter is indicated for evaluating the interventional therapy. The key to successful treatment of vascular injuries is immediate surgical control of hemorrhaging vessels.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2 a
Abb. 3 a
Abb. 4
Abb. 5 a
Abb. 6
Abb. 7 a,b
Abb. 8
Abb. 9 a,b
Abb. 10

Literatur

  1. Asensio JA, Berne JD, Chahwan, S et al. (1999) Traumatic injury to the superior mesenteric artery. Am J Surg 178:235–239

    Google Scholar 

  2. Asensio JA, Britt LD, Borzotta A et al. (2001) Multiinstitutional experience with the management of superior mesenteric artery injuries. J Am Coll Surg 193: 354–366

    Google Scholar 

  3. Aufmkolk M, Nast-Kolb D (2001) [Abdominal trauma]. Unfallchirurg 104: 861–875

    Google Scholar 

  4. Becker HM RI, Echave V, Heberer G (1986) Traumatic aneurysms of the descending Aorta. Ann Vasc Surg 1:196–200

    Google Scholar 

  5. Byrne DE PH, Crawford FA (1980) Traumatic vena cava injuries. Am J Surg 140:600–602

    Google Scholar 

  6. Carrillo EH, Bergamini TM, Miller FB, Richardson JD (1997) Abdominal vascular injuries. J Trauma 43:164–171

    Google Scholar 

  7. Clements RH, Fischer PJ 2nd (2001) Blunt injury of the intrapericardial great vessels. J Trauma 50:129–131

    Google Scholar 

  8. DeBakey M, Simeone F (1946) Battle injuries of arteries in World War II: an analysis of 2471 cases. Ann Surg 123:534

    Google Scholar 

  9. Graham JM, Mattox KL, Beall AC Jr (1978) Portal venous system injuries. J Trauma 18:419–422

    Google Scholar 

  10. Hansen CJ, Bernadas C, West MA, Ney AL, Muehlstedt S, Cohen M, Rodriguez JL (2000) Abdominal vena caval injuries: outcomes remain dismal. Surgery 128:572–578

    Google Scholar 

  11. Jurkovich GJ, Hoyt DB, Moore FA et al. (1995) Portal triad injuries. J Trauma 39:426–434

    Google Scholar 

  12. Kalmar P, Puschel K, Stubbe HM, Gultekin E (1996) [Delayed surgical therapy of acute aortic rupture]. Zentralbl Chir 121:750–755

    CAS  PubMed  Google Scholar 

  13. Kavic SM, Atweh N, Ivy ME, Possenti PP, Dudrick SJ (2001) Celiac axis ligation after gunshot wound to the abdomen: case report and literature review. J Trauma 50:738–739

    Google Scholar 

  14. Lachat M, Pfammatter T, Witzke H, Bernard E, Wolfensberger U, Kunzli A, Turina, M (2002) Acute traumatic aortic rupture: early stent-graft repair. Eur J Cardiothorac Surg 21:959–963

    Google Scholar 

  15. Lang, W, Verletzungen der Aorta abdominalis und der Beckenarterien, Gefaesschirurgie, 7 (2002):213–7.

  16. Larcan A, Fieve G (1986) [Louis Sencert, vascular surgeon (1878–1924)]. J Mal Vasc 11 [Suppl B]:68–74

  17. Linder F, Vollmer J (1965) Chirurg 36:50

    Google Scholar 

  18. McGwin G Jr, Reiff DA, Moran SG, Rue LW 3rd (2002) Incidence and characteristics of motor vehicle collision-related blunt thoracic aortic injury according to age. J Trauma 52:859–866

    Google Scholar 

  19. Orend K (2002) Verletzung der großen intrathorakalen und intraabdominellen Venen. Gefäßchirurgie 7:224–228

    Google Scholar 

  20. Orend KH, Kirchdorfer B, Sunder-Plassmann L (1996) Traumatic rupture of the descending thoracic aorta. Ann Ital Chir 67:21–25

    Google Scholar 

  21. Parmley LF MT, Marian WC (1958) Non-penetrating traumatic injury of the aorta. Circulation 17:1086–1100

    Google Scholar 

  22. Picard E, Marty-Ane CH, Meunier JP, Frapier JM, Seguin JR, Mary H, Chaptal PA (1995) Use of active shunt for surgical repair of intrapericardial inferior vena caval injury. Ann Thorac Surg 59:997–998

    Google Scholar 

  23. Pierangeli A, Turinetto B, Galli R, Caldarera L, Fattori R, Gavelli G (2000) Delayed treatment of isthmic aortic rupture. Cardiovasc Surg 8:280–283

    Google Scholar 

  24. Richardson JD, Bergamini TM, Spain DA et al. (1996) Operative strategies for management of abdominal aortic gunshot wounds: Surgery 120:667–671

    Google Scholar 

  25. Rousseau, H, Soula, P, Perreault P et al. (1999) Delayed treatment of traumatic rupture of the thoracic aorta with endoluminal covered stent. Circulation 99:498–504

    Google Scholar 

  26. Ruchholtz S, Nast-Kolb D, Waydhas C, Schweiberer L (1996) [The injury pattern in polytrauma. Value of information regarding accident process in clinical acute management]. Unfallchirurg 99:633–641

    Article  CAS  PubMed  Google Scholar 

  27. Varghese D, Patel H, Cameron EW, Robson M (2000) Repair of pulmonary vein rupture after deceleration injury. Ann Thorac Surg 70:656–658

    Google Scholar 

  28. von Oppell UO, Dunne TT, De Groot MK, ZillaP (1994) Traumatic aortic rupture: twenty-year metaanalysis of mortality and risk of paraplegia. Ann Thorac Surg 58:585–593

    PubMed  Google Scholar 

Download references

Interessenkonflikt:

Der korrespondierende Autor versichert, dass keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, bestehen.

Author information

Authors and Affiliations

  1. Abteilung für Thorax- und Gefäßchirurgie, Universitätsklinikum Ulm

    G. Halter & K.-H. Orend

  2. Abteilung für Thorax- und Gefäßchirurgie, Universitätsklinikum Ulm, Steinhövelstraße 9, 89075 , Ulm

    G. Halter

Authors
  1. G. Halter
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K.-H. Orend
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to G. Halter.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Halter, G., Orend, KH. Gefäßverletzungen im Thorax, Abdomen und Becken. Chirurg 76, 411–426 (2005). https://doi.org/10.1007/s00104-005-1014-1

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00104-005-1014-1

Schlüsselwörter

Keywords

Search

Navigation