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Magen und Duodenum

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Akutes Abdomen

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Zusammenfassung

Ulkusperforationen treten zwar aufgrund des verbreiteten Einsatzes von Protonenpumpeninhibitoren seltener auf, aber die zeitverzögerte Therapie ist noch immer mit einer hohen Letalität vergesellschaftet. Bei adäquater zeitnaher Diagnostik (< 24 h) ist eine laparoskopische Sanierung (Cave: Kontraindikationen) die Therapie der Wahl und beschleunigt den Heilungsverlauf. Die histologische Aufarbeitung des Ulkusmaterials ist obligat. Magenausgangstenosen erfordern grundsätzlich kein akutchirurgisches Vorgehen, jedoch sind eine Hospitalisierung des Patienten (Elektrolytverlust, Alkalose etc.) und eine exakte Diagnostik (häufig neoplastischer Grundprozess) notwendig. Diagnostisch ist eine Ösophagogastroduodenoskopie mit Biopsie unumgänglich. Therapeutisches Ziel (kurativ bzw. palliativ) ist die Wiederherstellung der Magen-Darm-Passage. Grundsätzlich ist bei beiden Erkrankungsbildern an eine Helicobacter-Eradikationstherapie zu denken.

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Authors and Affiliations

  1. Klinische Abteilung für Allgemeinchirurgie, Medizinische Universität Graz, Auenbruggerplatz 29, A-8036, Graz

    Dr. med. Andreas Puntschart

  2. Klinische Abteilung für Transplantationschirurgie, Medizinische Universität Graz, Auenbruggerplatz 29, A-8036, Graz

    Michael Sereinigg

  3. Chirurgische Abteilung LKH Graz Süd-West, Standort West, Göstinger Str. 22, A-8020, Graz

    Prim. Univ.-Prof. Dr. med. Hubert Hauser

Authors
  1. Dr. med. Andreas Puntschart
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  2. Michael Sereinigg
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  3. Prim. Univ.-Prof. Dr. med. Hubert Hauser
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Editor information

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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Puntschart, A., Sereinigg, M., Hauser, H. (2016). Magen und Duodenum. In: Hauser, H., Buhr, H., Mischinger, HJ. (eds) Akutes Abdomen. Springer, Vienna. https://doi.org/10.1007/978-3-7091-1473-5_40

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  • DOI: https://doi.org/10.1007/978-3-7091-1473-5_40

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-7091-1472-8

  • Online ISBN: 978-3-7091-1473-5

  • eBook Packages: Medicine (German Language)

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