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Diagnostische Strategien an Dünn- und Dickdarm

  • G. Feifel
Conference paper
Part of the Langenbecks Archiv für Chirurgie book series (DTGESCHIR, volume 1988)

Zusammenfassung

Wahl und Reihenfolge der verschiedenen diagnostischen Hilfsmittel — Abdomenübersicht, Kontrastmittelpassage, Sonographie, Endoskopie und Angiographie — richtet sich nach den Leitsymptomen bzw. nach der Verdachtsdiagnose. Sie wird außerdem beeinflußt von der Akuität der Erkrankung und von den Erfordernissen der Operationsplanung. Im Mastdarmbereich sind neuere bildgebende Verfahren wie Endosonographie und Computertomographie von Vorteil. Nur bei gezieltem Einsatz kann eine hohe diagnostische Ausbeute der radiologischen und endoskopischen Methoden erwartet werden.

Schlüsselwörter

Radiodiagnostik Endoskopie Sonographie 

Diagnostic Strategies in the Small Intestine and Large Bowel

Summary

The selection and sequence of different diagnostic procedures, such as abdominal X-ray, contrast roentgenography, ultrasonography, endoscopy and angiography, depend on the presenting symptoms and the presumptive diagnosis. In addition, the acuteness of the disease and the requirements for planning the operation determine the diagnostic time course. Novel image processing devices, such as endosonography and computerized tomography, may improve diagnosis, especially in rectal diseases. Successful outcome of diagnostic examinations can be achieved only by differentiated use of radiologic and endoscopic methods.

Keywords

Radiodiagnostics endoscopy ultrasonography 

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Literatur

  1. 1.
    Beyer D, Mödder U (1986) Diagnostik des akuten Abdomens mit bildgebenden Verfahren. Springer, Berlin Heidelberg New York TokyoGoogle Scholar
  2. 2.
    Dixon AK, Fry IK (1981) Pre-operative computed tomography of carcinoma of the rectum. Brit J Radiol 54:655–659PubMedCrossRefGoogle Scholar
  3. 3.
    Durdey P, Weston PMT, Williams NS (1987) Colonoscopy or barium enema as initial investigation of colonic disease. Lancet 1:549–551CrossRefGoogle Scholar
  4. 4.
    Feifel G, Hildebrandt U, Koch B (1987) Pseudoobstruktion des Darmes. Chirurg 58:585–589PubMedGoogle Scholar
  5. 5.
    Feifel G, Hildebrandt U, Dhom G (1987) Assessment of depth of invasion in rectal cancer by endosonography. Endoscopy 19:64–67PubMedCrossRefGoogle Scholar
  6. 6.
    Gianola FJ, Dwyer A, Jones AE, Sugarbaker PH (1984) Prospective studies of laboratory and radiologic tests in the management of colon and rectal cancer patients: I. Dis Col Rect, pp 811 – 818Google Scholar
  7. 7.
    Lee PWR (1976) The plain X-ray in the acute abdomen: a surgeon’s evaluation. Brit J Surg 63:763–766PubMedCrossRefGoogle Scholar
  8. 8.
    Lindsay DC, Freeman JG, Corbden I, Record CO (1988) Should colonoscopy be the first investigation for colonic disease? Brit Med J 296:167–178CrossRefGoogle Scholar
  9. 9.
    Longom WE, Ballantyne GH, Modlin IM (1988) Colonoscopic detection of early colorectal cancers. Ann Surg 207:174–178CrossRefGoogle Scholar
  10. 10..
    Lowman RM, Davis L (1956) An evaluation of cecal size in impending perforation of the cecum. Surg. Gynecol Obstet:711–718Google Scholar
  11. 11.
    Morris J, Stellato TA, Haaga JR, Lieberman J (1986) The utility of computed tomography in colonic diverticulitis. Ann Surg 204:128–132PubMedCrossRefGoogle Scholar
  12. 12.
    Nicholls J, Glass R (1985) Coloproctology. Diagnosis and outpatient management. Springer, Berlin Heidelberg New York TokyoCrossRefGoogle Scholar
  13. 13.
    Ott DJ, Gelfand DW (1983) Gastrointestinal contrast agents. Indications, uses, and risks. Jama 249:2380–2384PubMedCrossRefGoogle Scholar
  14. 14.
    Sarr MG, Bulkley GB, Zuidema GD (1983) Preoperative recognition of intestinal strangulation. Amer J Surg 145:176–182PubMedCrossRefGoogle Scholar
  15. 15.
    Stewart J, Finan PF, Courtney DF, Brennan TG (1984) Does a water soluble contrast enema assist in the management of acute large bowel obstruction: a prospective study of 117 cases. Brit J Surg 71:799–801PubMedCrossRefGoogle Scholar
  16. 16.
    Vellacott KD, Virjee J (1986) Audit on the use of the barium enema. Gut 27:182–185PubMedCrossRefGoogle Scholar
  17. 17.
    Wählby L, Knutsen OH (1982) Leukocyte counts, ESR and fever in the diagnosis of diverticulitis. Acta Chir Scand 148:623–624PubMedGoogle Scholar
  18. 18.
    Wilking N, Petrelli NJ, Herrera-Ornelas L, Walsh D, Mittelman A (1986) A comparison of the 25-cm rigid proctosigmoidoscope with the 65-cm flexible endoscope in the screening of patients for colorectal carcinoma. Cancer 57:669–671PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1988

Authors and Affiliations

  • G. Feifel
    • 1
  1. 1.Chirurgische UniversitätsklinikAbteilung für Allgemeine Chirurgie und AbdominalchirurgieHomburg/SaarDeutschland

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