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Magenmotilität — Entleerung, duodenogastraler Reflux

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Aktuelle gastroenterologische Diagnostik

Part of the book series: Interdisziplinäre Gastroenterologie ((GASTROENTEROLOG))

Zusammenfassung

Der Magen läßt sich hinsichtlich seiner Motilität in 2 Abschnitte unterteilen (Übersichten bei [54] und [65]): einen proximalen Abschnitt, bestehend aus Fundus und oralem Drittel des Korpus und einen distalen Abschnitt, bestehend aus den aboralen beiden Dritteln des Corpus, dem Antrum und dem Pylorus. Der proximale Abschnitt dient als Reservoir. Eine vorwiegend vagal vermittelte Druckregulation (rezeptive Relaxation und Akkomodation) reguliert die Flüssigkeitsentleerung. Nach Fundusresektion oder Vagotomie sinkt die Akkomodationsfähigkeit. Dadurch kommt es bei Füllung zum Druckanstieg und einer rascheren Entleerung von Flüssigkeiten. Der distale Magenabschnitt dient vorwiegend der Zerkleinerung fester Nahrungsbestandteile [38, 68]. Pathologische Veränderungen in diesem Magenteil schlagen sich deshalb in der Entleerung fester Mahlzeiten nieder. So führt eine Resektion von Antrum und Pylorus zu einer mangelhaften Zerkleinerung und überstürzten Entleerung fester Partikel [38]. Denervierung führt zu einer Stase fester Nahrungsbestandteile. Das Antrum hat wahrscheinlich keine Funktion in der Flüssigkeitsentleerung. Chirurgische Zerstörung des Pylorus hingegen läßt die Menge von Mageninhalt, die den Pylorus passiert, ansteigen. Da gleichzeitig jedoch der Reflux aus dem Duodenum erhöht wird, bleibt die Nettoentleerung der Flüssigkeiten aus dem Magen konstant [83, 84]. Eine dritte Form der Entleerung aus dem nicht operierten Magen stellt die Pyloruspassage nicht zerkleinerbarer Nahrungsbestandteile dar. Sie verbleiben im Magen, bis das digestive dem interdigestiven Motilitätsmuster Platz macht, und werden durch die Aktivitätsfront des ersten interdigestiven myoelektrischen Komplexes aus dem Magen entfernt [27, 80].

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  1. S. A. Müller-Lissner
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Editors and Affiliations

  1. Medizinische Klinik, Stadtspital Triemli, Birmensdorferstraße 497, CH-8063, Zürich, Switzerland

    André L. Blum

  2. Chirurgische Klinik und Poliklinik, Technische Universität MÆnchen, Klinikum rechts der Isar, Ismaninger Straße 22, D-8000, München 80, Germany

    Jörg Rüdiger Siewert (Direktor der Chirurgischen Klinik und Poliklinik der Technischen Universität München, Klinikum rechts der Isar) & Leo Lehr (Direktor der Chirurgischen Klinik und Poliklinik der Technischen Universität München, Klinikum rechts der Isar) & 

  3. I. Medizinische Abteilung, Städtischen Krankenhauses München-Neuperlach, Oskar-Maria-Graf-Ring 51, D-8000, München 83, Germany

    Rudolf Ottenjann

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Müller-Lissner, S.A. (1985). Magenmotilität — Entleerung, duodenogastraler Reflux. In: Blum, A.L., Siewert, J.R., Ottenjann, R., Lehr, L. (eds) Aktuelle gastroenterologische Diagnostik. Interdisziplinäre Gastroenterologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-70522-9_34

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