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Chronisch-entzündliche Darmerkrankungen

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Akutes Abdomen im Kindes- und Jugendalter
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Zusammenfassung

Bei M. Crohn stehen Gewichtsverlust, Wechsel von Durchfall und Obstipation, rezidivierende Bauchschmerzen und Analfisteln im Vordergrund. Die Colitis ulcerosa ist durch Schübe von schleimig-blutigen Durchfällen, Anämie und heftigen Bauchkrämpfen gekennzeichnet. Chronisch-entzündliche Darmerkrankungen (CED) zeigen charakteristische extraintestinale Manifestationen. Bei M. Crohn prägen intraabdominelle Fistelbildungen und Stenosen den Verlauf. Bei Colitis ulcerosa kann es zum toxischen Megakolon kommen. Die endoskopische Abklärung steht diagnostisch im Vordergrund. Bei M. Crohn ist eine Schichtbildgebung empfehlenswert. Die Behandlung der CED erfolgt primär konservativ, mit Immunsuppression, -modulation und Ernährungsumstellung. Darmstrikturen und Stenosen können endoskopisch dilatiert werden. Die chirurgische Therapie bei M. Crohn umfasst die Therapie von Darmstenosen, enteroenterischen Fistelbildungen und Abszessen. Bei Colitis ulcerosa führt eine Proktokolektomie mit J-Pouch-Anlage zur Besserung.

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Mayr, J., Fasching, G. (2018). Chronisch-entzündliche Darmerkrankungen . In: Mayr, J., Fasching, G. (eds) Akutes Abdomen im Kindes- und Jugendalter. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-55995-6_21

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  • DOI: https://doi.org/10.1007/978-3-662-55995-6_21

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