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Akutes Abdomen pp 375-387 | Cite as

Ösophagus

  • Jacob R. Izbicki
  • Bianca T. Hofmann
  • Alexandra M. König
  • Stefan Groth
  • Thomas Rösch
  • Asad Kutup

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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Copyright information

© Springer-Verlag Wien 2016

Authors and Affiliations

  • Jacob R. Izbicki
    • 1
  • Bianca T. Hofmann
    • 1
  • Alexandra M. König
    • 1
  • Stefan Groth
    • 2
  • Thomas Rösch
    • 2
  • Asad Kutup
    • 1
  1. 1.Klinik für Allgemein-, Viszeral- und ThoraxchirurgieUniversitätsklinikum Hamburg-EppendorfHamburg
  2. 2.Klinik und Poliklinik für Interdisziplinäre EndoskopieUniversitätsklinikum Hamburg-EppendorfHamburg

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