0000000000589942
AUTHOR
C. Kelbel
Die sonographische Gallenblasenwandverdickung und ihre diagnostische Bedeutung bei intensivpflichtigen Patienten
In a prospective study including 398 intensive-care patients, we analysed the ultrasonographic relevance of a gallbladder wall thickening. In 24 of 398 (6%) cases a wall thickening was found that could be differentiated into two types of walls. In 20.8% (5/24) the gallbladder wall thickening was an expression of an acute cholecystitis. In further differential diagnosis of a gallbladder wall thickening pathological states with hypoalbuminaemia occupy the prime position. The pathological mechanism has not yet been completely clarified. Hypoalbuminaemia without inflammatory alterations of the organ was found in 37.5% of the cases with gallbladder wall thickening. In 41.6% of the patients the w…
Einsatz von niedermolekularem Heparin zur Antikoagulation in der Schwangerschaft
A 26-year-old woman, on bedrest since the 6th week of pregnancy because of threatened abortion, developed thrombosis in the left iliac, superficial femoral and common femoral veins with small pulmonary emboli in the 11th week. Inhibitor deficiency was excluded. The thrombosis was only partially recanalized by unfractionated heparin at therapeutic dosage (38,400 IU per 24 h). As thrombolysis treatment and oral anticoagulation were contraindicated because of the threatened abortion, coagulation with low molecular weight heparin (LMWH) was started in the 18th week (5000 anti-Xa units daily subcutaneously). Maximal anti-Xa activity in plasma never exceeded 0.3 U/ml and there were no complicatio…
Diagnostik von Pleuraergüssen bei intensivpflichtigen Patienten: Sonographie und Radiologie im Vergleich
Die Sonographie hat als unbelastende und leicht durchzufuhrende Untersuchungsmethode ihren festen Platz auch auf der Intensivstation. Hier konnen u. a. Pleuraergusse beim liegenden Patienten mit hoher Sensitivitat nachgewiesen werden [1–5] und zusatzlich, wie wir zeigen konnten, sicher volumetriert werden [2].
Diagnostik von Pleuraergüssen und Atelektasen: Sonographie und Radiologie im Vergleich
In a prospective study it was shown that chest ultrasonography is superior to conventional x-ray diagnosis of recumbent patients in diagnosing pleural effusion and lung atelectasis. In 110 supine radiographs we found a sensitivity of 47% and a specificity of 71% for right pleural effusions and a sensitivity of 55% and a specificity of 93% for left pleural effusions in comparison to 110 sonographic examinations. The results of supine radiographs in detection of atelectasis were less efficient: sensitivity for the right side: 7%; sensitivity for the left side: 13.5%. Hence, the knowledge of chest ultrasonographic diagnosis can improve the interpretation of supine radiographs.