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Endoskopische und interventionelle Therapie von Ösophagusperforationen

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Benigne Ösophaguserkrankungen

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Zusammenfassung

Ösophagusperforationen mit einer vollständigen pathologischen Eröffnung aller Anteile der Ösophaguswand sind eine schwerwiegende Erkrankung. Diese kann durch Verletzungen, Verätzungen oder auch Einrisse entstehen. Das klinische Bild einer Ösophagusperforation ist extrem variabel, was zunächst oftmals zu einer falschen Diagnose sowie zu einem verzögerten Therapiebeginn führt. Aufgrund der hohen Rate an Komorbiditäten mit meist begleitender Mediastinitis und Sepsis ist die Ösophagusperforation mit einer Mortalitätsrate von 15–50 % hoch. Dabei hängt die Mortalitätsrate von der Höhe der Perforation ab. So liegt die Mortalitätsrate von Patienten mit zervikalen Perforationen bei 6–20 %. Die Mortalitätsrate bei abdominellen Perforationen liegt bei 3–22 % und somit auf einem ähnlichen Niveau wie die der zervikalen Perforationen. Bei Patienten mit thorakalen Perforationen ist die Mortalitätsrate mit 5,4–36 % etwas höher. Verschiedene Studien konnten zeigen, dass das Überleben der Patienten maßgeblich von der Zeitspanne zwischen der Diagnosestellung und Therapiebeginn abhängt.

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Authors and Affiliations

  1. Praxis für Enddarmkrankheiten und Endoskopie, Kiel, Deutschland

    Dr.med Nils Heits

  2. Klinik für Innere Medizin I, Universitätsklinikum Schleswig – Holstein, Kiel, Deutschland

    Prof. Dr.med Mark Ellrichmann

  3. Abteilung für Allgemein-, Viszeral-, Gefäß- und Transplantationschirurgie, Universitätsmedizin Rostock, Chirurgische Klinik und Poliklinik, Rostock, Deutschland

    Prof. Dr.med Clemens Schafmayer

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  1. Klinik und Poliklinik für Viszeral-, Transplantations-, Thorax- und Gefäßchirurgie, Universitätsklinikum Leipzig, Leipzig, Germany

    Ines Gockel

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Heits, N., Ellrichmann, M., Schafmayer, C. (2021). Endoskopische und interventionelle Therapie von Ösophagusperforationen. In: Gockel, I. (eds) Benigne Ösophaguserkrankungen. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-60455-7_27

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