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Ösophagus

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Akutes Abdomen

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Zusammenfassung

Iatrogene Ösophagusperforationen sind eher klein (1–3 cm) und können überwiegend mit einer konservativ-interventionellen Therapie behandelt werden. Begleitend finden sich häufig thorakale Flüssigkeitsansammlungen, sodass hier Thoraxdrainagen oder ggf. radiologisch-interventionell Drainagen platziert werden müssen. Bei Versagen der initial begonnenen konservativen Behandlung mit Zeichen einer Mediastinitis und oder Sepsis müssen umgehend operative Verfahren zur Anwendung kommen. Entscheidend für das Outcome der Patienten ist ein Therapiebeginn innerhalb der ersten 24 h. Als chirurgische Optionen stehen die Übernähung und Deckung des Defekts oder die Ösophagektomie mit Rekonstruktion oder Diskontinuitätsresektion zur Verfügung. Das Ziel aller Therapieformen ist die Behandlung der mediastinalen Infektion und die Verhinderung einer Sepsis mit fortschreitenden Organsystemausfällen.

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Authors and Affiliations

  1. Klinik für Allgemein-, Viszeral- und Thoraxchirurgie, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, D-20246, Hamburg

    Prof. Dr. med. Prof. h.c. Dr. h.c. Jacob R. Izbicki, Dr. med. Bianca T. Hofmann, Priv.-Doz. Dr. med. Alexandra M. König & Priv.-Doz. Dr. med. Asad Kutup

  2. Klinik und Poliklinik für Interdisziplinäre Endoskopie, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, D-20246, Hamburg

    Dr. med. Stefan Groth & Prof. Dr. med. Thomas Rösch

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  1. Prof. Dr. med. Prof. h.c. Dr. h.c. Jacob R. Izbicki
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  2. Dr. med. Bianca T. Hofmann
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  3. Priv.-Doz. Dr. med. Alexandra M. König
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Editors and Affiliations

  1. LKH Graz Süd-West, Chirurgie, Graz, Österreich

    Hubert Hauser

  2. DGAV e.V., Berlin, Deutschland

    Heinz Johannes Buhr

  3. Universitätsklinik für Chirurgie, Graz, Österreich

    Hans-Jörg Mischinger

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Izbicki, J., Hofmann, B., König, A., Groth, S., Rösch, T., Kutup, A. (2016). Ösophagus. In: Hauser, H., Buhr, H., Mischinger, HJ. (eds) Akutes Abdomen. Springer, Vienna. https://doi.org/10.1007/978-3-7091-1473-5_39

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  • DOI: https://doi.org/10.1007/978-3-7091-1473-5_39

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