Zusammenfassung
Verletzungen und Erkrankungen der Milz, mit einem sich unter Umständen ergebenden Milzverlust, können erhebliche Relevanz für die ärztliche Begutachtung haben. Allgemein wird zwischen traumatischen und atraumatischen Erkrankungen bzw. Verletzungen unterschieden. Selten kann es zu atraumatischen Spontanrupturen der Milz durch entzündliche, infektiöse oder hämatologische Erkrankungen kommen. Darüber hinaus ist zwischen der akuten, einzeitigen Ruptur und einer verzögerten, zweizeitigen Ruptur zu unterscheiden. Diagnostische Mittel der Wahl sind die Sonografie und die Computertomografie. Wenn bei ausgedehnten Verletzungen eine operative Therapie indiziert ist, dann sollte das Ziel der Milzerhalt ohne Gefährdung des Patienten sein. Bei instabilen polytraumatisierten Patienten und kompletter Zerstörung des Organs ist dagegen eine Splenektomie indiziert.
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Literatur
Aubrey-Bassler FK, Sowers N (2012) 613 cases of splenic rupture without risk factors or previously diagnosed disease: a systematic review. BMC Emerg Med 12(1):11. https://doi.org/10.1186/1471-227X-12-11
Bessoud B, Duchosal MA, Siegrist CA et al (2007) Proximal splenic artery embolization for blunt splenic injury: clinical, immunologic, and ultrasound-doppler follow-up. J Trauma Inj Infect Crit Care 62(6):1481–1486. https://doi.org/10.1097/TA.0b013e318047dfb8
Bruce PJP, Helmer SD, Harrison PB, Sirico T, Haan JM (2011) Nonsurgical management of blunt splenic injury: is it cost effective? Am J Surg 202:810–816. https://doi.org/10.1016/j.amjsurg.2011.06.041
Ekeh AP, Khalaf S, Ilyas S, Kauffman S, Walusimbi M, McCarthy MC (2013) Complications arising from splenic artery embolization: a review of an 11-year experience. Am J Surg 205(3):250–254. https://doi.org/10.1016/j.amjsurg.2013.01.003
Goddard SL, Chesney AE, Reis MD et al (2007) Pathological splenic rupture: a rare complication of chronic myelomonocytic leukemia. Am J Hematol 82(5):405–408. https://doi.org/10.1002/ajh.20812
Grossi U, Crucitti A, D’Amato G et al (2011) Laparoscopic splenectomy for atraumatic splenic rupture. Int Surg 96(1):87–89. https://doi.org/10.9738/1382.1
Guth AA, Pachter HL, Jacobowitz GR (1996) Rupture of the pathologic spleen. J Trauma Inj Infect Crit Care 41(2):214–218. https://doi.org/10.1097/00005373-199608000-00003
Haan JM, Bochicchio GV, Kramer N, Scalea TM (2005) Nonoperative management of blunt splenic injury: a 5-year experience. J Trauma Inj Infect Crit Care 58(3):492–498. https://doi.org/10.1097/01.TA.0000154575.49388.74
Hernani BL (2015) Acute pancreatitis complicated with splenic rupture: a case report. World J Gastrointest Surg 7(9):219. https://doi.org/10.4240/wjgs.v7.i9.219
Klotz S, Semik M, Senninger N, Berendes E, Scheld HH (2003) Spontaneous splenic rupture after a left-side thoracotomy: report of a case. Surg Today 33(8):636–638. https://doi.org/10.1007/s00595-003-2535-1
Kocael PC, Simsek O, Bilgin IA et al (2014) Characteristics of patients with spontaneous splenic rupture. Int Surg 99(6):714–718. https://doi.org/10.9738/INTSURG-D-14-00143.1
Liu J, Feng Y, Li A, Liu C, Li F (2019) Diagnosis and treatment of atraumatic splenic rupture: experience of 8 cases. Gastroenterol Res Pract 2019. https://doi.org/10.1155/2019/5827694
Olthof DC, Joosse P, Van Der Vlies CH, De Haan RJ, Goslings JC (2013) Prognostic factors for failure of nonoperative management in adults with blunt splenic injury: a systematic review. J Trauma Acute Care Surg 74(2):546–557. https://doi.org/10.1097/TA.0b013e31827d5e3a
Palada I, Eterović D, Obad A et al (2007) Spleen and cardiovascular function during short apneas in divers. J Appl Physiol 103(6):1958–1963. https://doi.org/10.1152/japplphysiol.00182.2007
Raaijmakers CP, Lohle PN, Lodder P, de Vries J (2019) Quality of life and clinical outcome after traumatic spleen injury (SPLENIQ study): protocol for an observational retrospective and prospective cohort study. JMIR Res Protoc 8(5):e12391. https://doi.org/10.2196/12391
Renzulli P, Schoepfer A, Mueller E, Candinas D (2009a) Atraumatic splenic rupture in amyloidosis. Amyloid 16(1):47–53. https://doi.org/10.1080/13506120802676922
Renzulli P, Hostettler A, Schoepfer AM, Gloor B, Candinas D (2009b) Systematic review of atraumatic splenic rupture. Br J Surg 96(10):1114–1121. https://doi.org/10.1002/bjs.6737
Ringburg AN, Polinder S, Van Ierland MCP et al (2011) Prevalence and prognostic factors of disability after major trauma. J Trauma Inj Infect Crit Care 70(4):916–922. https://doi.org/10.1097/TA.0b013e3181f6bce8
Rosati C, Ata A, Siskin GP, Megna D, Bonville DJ, Stain SC (2015) Management of splenic trauma: a single institution’s 8-year experience. Am J Surg. 209(2):308–314. https://doi.org/10.1016/j.amjsurg.2014.06.034
Saad A, Rex DK (2008) Colonoscopy-induced splenic injury: report of 3 cases and literature review. Dig Dis Sci 53(4):892–898. https://doi.org/10.1007/s10620-007-9963-5
Sluys K, Häggmark T, Iselius L (2005) Outcome and quality of life 5 years after major trauma. J Trauma Inj Infect Crit Care 59(1):223–232. https://doi.org/10.1097/01.TA.0000173832.01547.CB
Sylvester JE, Buchanan BK, Paradise SL, Yauger JJ, Beutler AI (2019) Association of splenic rupture and infectious mononucleosis: a retrospective analysis and review of return-to-play recommendations. Sports Health 11(6):543–549. https://doi.org/10.1177/1941738119873665
Trinci M, Giangregorio C, Calabrese G et al (2019) A rare case of non-traumatic intrasplenic pseudoaneurysms in a patient with acute T-cell lymphoblastic leukemia. J Ultrasound. https://doi.org/10.1007/s40477-019-00401-5
Weaver H, Kumar V, Spencer K, Maatouk M, Malik S (2013) Spontaneous splenic rupture: a rare life-threatening condition; diagnosed early and managed successfully. Am J Case Rep. 14:13–15. https://doi.org/10.12659/AJCR.883739
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Schöffel, N., Thielemann, H. (2022). Erkrankungen und Verletzungen der Milz. In: Breuer, J., Fritze, J., Popa, A., Scholtysik, D., Seifert, J., Wich, M. (eds) Die Ärztliche Begutachtung. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-61937-7_105-1
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