Zusammenfassung
Die intestinale Durchblutung nimmt pathophysiologisch eine Sonderstellung ein. Zwar sind atherosklerotische Einengungen der drei Hauptäste (Truncus coeliacus, A. mesenterica superior, A. mesenterica inferior) ebenso häufig wie im Bereich anderer peripherer Arterien [1, 2], klinisch wirken sich jedoch arterielle Obstruktionen wesentlich seltener aus, als dies von der Inzidenz der pathologischen Veränderung zu erwarten wäre. Der Grund liegt in der ausgedehnten Kollateralisationsmöglichkeit des gesamten intestinalen Gefäßbettes. Die drei wichtigsten Kollateralwege sind:
-
die Riolan-Anastomose von der A. mesenterica superior zur A. mesenterica inferior,
-
die pankreatikoduodenale Arkade vom Truncus coeliacus zur A. mesenterica superior sowie
-
die Verbindung zwischen A. mesenterica inferior zur A. iliaca interna via A. recta-lis.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
Literatur
Graft RJ, Menon GP, Marston A (1981) Does intestinal angina exist? A critical study of obstructed visceral arteries. Br J Surg 68: 316
Larsen RO, Lindenauer SM, Stanley JC (1980) Splanchnic arteriosclerotic disease and intestinal angina. Arch Surg 115: 497
Marston A, Clarke JMF, Garcia Garcia J, Miller AL (1985) Intestinal function and intestinal blood supply: a 20 year surgical study. Gut 26: 656
Mikkelson WP (1957) Intestinal angina: its surgical significance. Am J Surg 94: 262
Gillespie IE (1985) Intestinal ischemia. Gut 26: 653
Stoney RJ, Wylie EJ (1966) Recognition and management of visceral ischemic syndromes. Ann Surg 1964: 714
Charrette EP, Iyengar RK, Lynn RB, Paloschi GB, West RO (1971) Abdominal pain associated with celiac artery compression. Surg Gynecol Obstet 132: 1009
Levin DC, Baltaxe HA (1972) High incidence of celiac axis narrowing in asymptomatic individuals. AJR 116: 426
Szilagyi DE, Rian RL, Elliott JP, Smith RF (1972) The celiac artery compression syndrome: does it exist? Surgery 72: 849
Colapinto RF, McCoughlin MJ, Weisbrod GL (1972) The routine lateral aortogram and the celiac axis syndrome. Radiology 103: 557
Babb RR (1973) Auscultation of the abdomen with reference to vascular sounds. Am J Dig Dis 18: 1058
Sarr MG, Dickinson ER, Newcomer AD (1980) Diastolic bruit in chronic intestinal ischemia. Recognition by abdominal phonoangiography. Dig Dis Sci 25: 761
Jäger KA, Frauchiger B, Eichlisberger R, Beglinger C (1992) Evaluation of the gastrointestinal vascular system by duplex sonography: 197. In: Labs KH, Jäger KA, Fitzgerald DE, Woodcock JP, Neuerburg-Heusler D (eds) Diagnostic vascular ultrasound. Arnold, London
Jäger K, Bollinger A, Valli C, Ammann R (1986) Measurement of mesenteric blood flow by duplex scanning. J Vasc Surg 3: 462
Münch R, Jäger K (1988) Duplexsonographie — eine Erweiterung der Diagnostik mesenterialer Durchblutungsstörungen. Schweiz Rundschau Med Prax 77: 51
Werth B, Heer M, Beglinger C, Jäger K (1989) Postprandial superior mesenteric artery blood flow (SMABF) response in patients with different gastrointestinal disorders. Gastroenterology 96: A542
Stimpel M, Groth H, Greminger P, Lüscher TF, Vetter H, Vetter W (1985) The spectrum of renovascular hypertension. Cardiology [Suppl] 1/1: 72
Berglund G, Andersson O, Wilhelmsen L (1976) Prevalence of primary and secondary hypertension: studies in a random population sample. Br Med J 2: 554
Capelli JP, Housel EL, Zimskind PD et al. (1979) Renovascular hypertension: prospective diagnostic yield in a random access population. Urology 2: 324
Davis BA, Crook JE, Vestal RE et al. (1979) Prevalence of renovascular hypertension in patients with grade II or IV hypertensive retinopathy. N Engl J Med 30: 273
Lewin A, Blaufox D, Castel H et al. (1985) Apparent prevalence of curable hypertension in the hypertension detection and follow-up programme. Arch Intern Med 245: 424
Working Group on Renovascular Hypertension (1987) Detection, evaluation and treatment of renovascular hypertension: final report. Arch Intern Med 147: 820
Svetkey LP, Himmelstein SI, Dunnick NR et al. (1987) Prospective analysis of strategies for diagnosing renovascular hypertension. Hypertension 14: 247
Simon N, Franklin SS, Bleifer KH, Maxwell MH (1972) Clinical characteristics of renovascular hypertension. JAMA 220: 1209
Hunt JC, Sheps SG, Harrison EG et al. (1974) Renal and renovascular hypertension: a recent approach to diagnosis and management. Arch Intern Med 133: 988
Eipper DF, Gifford RW Jr, Stewart BH et al. (1976) Abdominal bruits in renovascular hypertension. Am J Cardiol 34: 48
Dubbins PA (1986) Renal artery stenosis: Duplex Doppler evaluation. Br J Radiol 59: 225
Handa N, Fukunaga R, Etani H, Yoneda S, Kimura K, Kamada T (1988) Efficacy of echodoppler examination for the evaluation of renovascular disease. Ultrasound Med Bio 14: 1
Robertson R, Murphy A, Dubbins PA (1988) Renal artery stenosis: The use of duplex ultrasound as screening technique. Br J Radiol 196: 61
Kohler TR, Zierler RE, Martin RL et al. (1986) Non-invasive diagnosis of renal artery stenosis by ultrasonic duplex scanning. J Vasc Surg 4: 450
Hoffmann U, Edwards J, Carter S, Goldman M, Harley J, Zaccardi M, Strandness E (1991) Role of duplex scanning for the detection of atherosclerotic renal artery disease. Kidney Int 39:1232
Avasti PS, Voyles WF, Greene ER (1984) Noninvasive diagnosis of renal artery stenosis by echo-Doppler velocymetry. Kidney Int 25: 428
Ferretti G, Salomone A, Castagno PL, Miglietti P, Rispoli P (1988) Renovascular hypertension: a non-invasive Duplex scanning screening. Inter Angio 7: 219
Schreiber MJ, Pohl MA, Novick AC (1984) The natural history of atherosclerotic and fibrous renal artery disease. Urol Clin Noth Am 11: 383
Adams MB, Harris SS, Kauffmann HM, Towne JB (1984) Effect of primary renal disease in patients with renovascular insufficiency. J Vasc Surg 1: 482
Kuhlmann U, Wehling M, Vetter W et al. (1983) Häufigkeit und Bedeutung von Nierenarterienstenosen bei Patienten mit peripherer arterieller Verschlußkrankheit. Klin Wochenschr 61: 339
Landwehr DM, Vetrovec GW, Cowley MJ et al. (1983) Association of renal artery stenosis with coronary artery disease in patients with hypertension and/or chronic renal insufficiency. Am Soc Nephrol (Abstract): 33A
Novick AC (1989) Current concepts in the management of renovascular hypertension and ischemic renal failure. Am J Kidney Dis 13: 33
Marks LS, Maxwell MH (1975) Renal vein renin: Value and limitations in the prediction of operative results. Urol Clin Noth Am 2: 311
Müller FB, Sealey JE, Case DB et al. (1986) The Captopril test for identifying renovascular disease in hypertensive patients. Am J Med 80: 633
Lüscher TF, Greminger P, Siegenthaler W, Vetter W (1986) Renal venous renin determination in renovascular hypertension: Diagnostic and prognostic value in unilateral renal artery stenosis treated by surgery or percutaneous transluminal angioplasty. Nephron 44: 17
Kuhlmann U, Greminger P, Gruentzig A et al. (1985) Long-term experience in percutaneous transluminal dilatation of renal artery stenosis. Am J Med 692: 79
Jäger K (1991) Moderne Möglichkeiten bei der Abklärung renovaskulärer Stenosen: Internist 32: 127
Frauchiger B, Eichlisberger R, Jäger K (1993) Renovaskuläre Hypertonie. In: Nephrologie für die Praxis. Franz H, Riesler A (Hrsg) Ecomed
Postma C, van de Stenn P, Hoefnagels W, de Boo T, Thien T (1990) The Captopril test in the detection of renovascular disease of hypertensive patients. Arch Intern Med 150: 625
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1994 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Frauchiger, B., Eichlisberger, R., Jäger, K.A. (1994). Rationelle Diagnostik bei Verdacht auf viszerale und renale Durchblutungsstörungen. In: Jäger, K.A., Landmann, J. (eds) Praxis der angiologischen Diagnostik. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-78874-1_10
Download citation
DOI: https://doi.org/10.1007/978-3-642-78874-1_10
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-78875-8
Online ISBN: 978-3-642-78874-1
eBook Packages: Springer Book Archive