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Zusammenfassung

Gefäßerkrankungen des Dünndarms und Kolons umfassen neben der akuten mesenterialen Ischämie (arterielle Embolie, arterielle Thrombose, nichtokklusive Ischämie) und der Mesenterialvenenthrombose die chronische mesenteriale Ischämie unterschiedlicher Ursachen. Die akute mesenteriale Ischämie ist ein lebensbedrohlicher Notfall mit einer nach wie vor erschreckend hohen Letalität von über 50%. Die klinischen Erscheinungsformen werden von Art und Ausmaß der vaskulären Läsion und von der zugrunde liegenden Erkrankung bestimmt. Wesentliche Determinante der Prognose ist die Geschwindigkeit der Diagnose. Da bislang keine einfachen diagnostischen Tests mit ausreichender Sensitivität und Spezifität zur Verfügung stehen, erfolgt die Diagnose im Wesentlichen durch angiographische Verfahren.

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Literatur

  • American Gastroenterological Association Medical Position Statement (2000) Guidelines on intestinal ischemia. Gastroenterology 118:951–953

    Article  Google Scholar 

  • Aschoff AJ, Stuber G, Becker BW, Hoffmann MHK, Schmitz BL, Schelzig H, Jaeckle T (2008) Evaluation of acute mesenteric ischemia: accuray of biphasic mesenteric multi-detector CT angiography. Abdom Imaging 34: 345–357

    Article  Google Scholar 

  • Brandt LJ, Boley SJ (2000) AGA Technical review on intestinal ischemia. Gastroenterology 118:954–968

    Article  PubMed  CAS  Google Scholar 

  • Bruch HP, Broll R, Wunsch P, Schindler G (1989) Zum Problem der nicht-okklusiven ischämischen Enteropathie (NOD). Diagnose, Therapie und Prognose. Chirurg 60:419–425

    PubMed  CAS  Google Scholar 

  • Cademartiri F, Raaijmakers RH, Kuiper JW, van Dijk LC, Pattynama PM, Krestin GP (2004) Multi-detector row CT angiography in patients with abdominal angina. Radiographics 24:969–984

    Article  PubMed  Google Scholar 

  • Cappell MS (1998) Intestinal (mesenteric) vasculopathy I: Acute superior mesenteric arteriopathy and venopathy. Gastroenterol Clin North Am 27:783–825

    Article  PubMed  CAS  Google Scholar 

  • Carlos RC, Standley JC, Stafford-Johnson D, Prince MR (2001) Interobserver variability in the evaluation of chronic mesenteric ischemia with gadolinium-enhanced MR angiography. Acad Radiol 8:879–887

    Article  PubMed  CAS  Google Scholar 

  • Demertzis S, Ringe B, Gulba D, Rosenthal H, Pichlmayr R (1994) Treatment of portal vein thrombosis by thrombectomy and regional thrombolysis. Surgery 115:389–393

    PubMed  CAS  Google Scholar 

  • Eckstein HH (2003) Die akute mesenteriale Ischämie. Chirurg 74:419–431

    Article  PubMed  Google Scholar 

  • Grothues F, Bektas H, Klempnauer J (1996) Chirurgische Therapie akuter mesenterialer Ischämien. Langenbecks Arch Chir 381:275–282

    Article  PubMed  CAS  Google Scholar 

  • Heiss P, Zorger N, Kaempfe I, Jung EM, Pfister K, Paetzel C, Feuerbach S, Herold T (2008) Chronische mesenteriale Ischämie: Technische und klinische Erfolgsrate der perkutanen Stentangioplastie. Fortschr Röntgenstr 180:906–914

    CAS  Google Scholar 

  • Heiss, P, Loewenhardt B, Manke C, Hellinger A, Dietl KH, Schlitt HJ, Scheibl K, Feuerbach S, Paetzel C (2010) Primary percutaneous aspiration and thrombolysis for the treatment of acute embolic superior mesenteric artery occlusion. Eur Radiol 20:2948–2958

    Article  PubMed  Google Scholar 

  • Horgan PG, Gorey TF (1992) Operative assessment of intestinal viability. Surg Clin North Am 72:143–155

    PubMed  CAS  Google Scholar 

  • Inderbitzi R, Hassler H, Teuscher J, Stirnemann P (1990) Die akute mesenteriale Ischämie. Chirurg 61:530–534

    PubMed  CAS  Google Scholar 

  • Järvinen O, Laurikka J, Sisto T, Salenius JP, Takka MR (1995) Atherosclerosis of the visceral arteries. VASA 24:9–14

    PubMed  Google Scholar 

  • Knichwitz G, Kruse C, van Aken H (2004) Intestinale Perfusionsstörungen beim Intensivpatienten. Anaesthesist DOI 10.1007/s00101–004–0769-y

    Google Scholar 

  • Kozuch PL, Brandt LJ (2005) Review article: diagnosis and management of mesenteric ischaemia with an emphasis on pharmacotherapy. Aliment Pharmacol Ther 21:201–215

    Article  PubMed  CAS  Google Scholar 

  • Kurland B, Brandt LJ, Delany HM (1992) Diagnostic tests for intestinal ischemia. Surg Clin North Am 72:85–105

    PubMed  CAS  Google Scholar 

  • Lauenstein TC, Ajaj W, Narin B, Göhde SC, Kröger K, Debatin JF, Rühm SG (2005) MR imaging of apparent small-bowel perfusion for diagnosing mesenteric ischemia: feasibility study. Radiology 234:569–575

    Article  PubMed  Google Scholar 

  • Lock G (2001) Acute intestinal ischemia. In: Tytgat GNT, Schölmerich J (eds) Baillière’s best practice & research clinical gastroenterology 15.1. Bailliere Tindall, Eastbourne, UK, 83–98

    Google Scholar 

  • Lock G, Schölmerich J (2004) Die mesenteriale Ischämie. Intensivmed 41:153–162

    Article  Google Scholar 

  • Mamode N, Pickford I, Leiberman P (1999) Failure to improve outcome in acute mesenteric ischaemia: seven-year review. Eur J Surg 165:203–238

    Article  PubMed  CAS  Google Scholar 

  • Menke J (2010) Diagnostic accuracy of multidetector CT in acute mesenteric ischemia: systematic review and meta-analysis. Radiology 256:93–101

    Article  PubMed  Google Scholar 

  • Mitsuyoshi A, Obama K, Shinkura N, Ito T, Zaima M (2007) Survival in nonocclusive mesenteric ischemia. Early diagnosis by multidetector row computed tomography and early treatment with continuous intravenous high-dose prostaglandin E1. Ann Surg 246:229–235

    Article  PubMed  Google Scholar 

  • Moawad J, Gewertz BL (1997) Chronic mesenteric ischemia: clinical presentation and diagnosis. Surg Clin North Am 77:357–370

    Article  PubMed  CAS  Google Scholar 

  • Müller-Ladner U (2001) Vasculitides of the gastrointestinal tract. In: Tytgat GNT, Schölmerich J (eds) Baillière’s best practice & research clinical gastroenterology 15.1. Bailliere Tindall, Eastvourne, UK, 59–82

    Google Scholar 

  • Rhee RY, Gloviczki P (1997) Mesenteric venous thrombosis. Surg Clin North Am 77:327–338

    Article  PubMed  CAS  Google Scholar 

  • Roobottom CA, Dubbins PA (1995) Significant disease of the celiac and superior mesenteric arteries in asymptomatic patients: Predictive value of Doppler Sonographie. Amer J Radiol 161:985–988

    Google Scholar 

  • Schermerhorn ML, Giles KA, Hamdan AD, Wyers MC, Pomposelli FB (2009) Mesenteric revascularization: management and outcomes in the United States, 1988–2006. J Vasc Surg 50:341–348

    Article  PubMed  Google Scholar 

  • Schneider TA, Longo WE, Ure T, Vernava AM III (1994) Mesenteric ischemia – acute arterial syndromes. Dis Colon Rectum 37:1163–1174

    Article  PubMed  CAS  Google Scholar 

  • Schoots IG, Koffeman GI, Legemate DA, Levi M, van Gulik TM (2004) Systematic review of survival after acute mesenteric ischaemia according to disease aetiology. Br J Surg 91:17–27

    Article  PubMed  CAS  Google Scholar 

  • Schoots IG, Levi MM, Reekers JA, Lameris JS, van Gulik TM (2005) Thrombolytic therapy for acute superior mesenteric artery occlusion. J Vasc Interv Radiol 16:317–329

    PubMed  Google Scholar 

  • Wadman M, Block T, Ekberg O, Syk I, Elmståhl S, Acosta S (2010) Impact of MDCT with intravenous contrast on the survival in patients with acute superior mesenteric artery occlusion. Emerg Radiol 17:171–178

    Article  PubMed  Google Scholar 

  • Woodhams R, Nishimaki H, Fujii K, Kakita S, Hayakawa K (2010) Usefulness of multidetector-row CT (MDCT) for the diagnosis of nonocclusive mesenteric ischemia (NOMI): Assessment of morphology and diameter of superior mesenteric artery (SMA) on multiplanar reconstructed (MPR) images. Eur J Radiol 76:96–102

    Article  PubMed  Google Scholar 

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Schölmerich, J., Herfarth, C. (2011). Gefäßerkrankungen des Dünndarms und des Kolons. In: Siewert, J.R., Rothmund, M., Schumpelick, V. (eds) Praxis der Viszeralchirurgie. Gastroenterologische Chirurgie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-14223-9_30

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  • DOI: https://doi.org/10.1007/978-3-642-14223-9_30

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-14222-2

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