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Hirschsprung-assoziierte Enterokolitis

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Akutes Abdomen im Kindes- und Jugendalter

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Zusammenfassung

Eine Hirschsprung assoziierte Enterokolitis (HAEC) kann vor oder nach einer Durchzugsoperation auftreten. Ein massiv distendiertes, weiches Abdomen, diffuse Bauchschmerzen, hohes Fieber, grünes Erbrechen oder Miserere und Stuhlverhalt prägen die Symptomatik. Unbehandelt kommt es zu einer raschen Verschlechterung des Allgemeinzustands mit Ausbildung eines Multiorganversagens. Eine rektal-digitale Untersuchung führt zur Entleerung von übelriechendem Stuhl unter hohem Druck. Eine Abdomenleerröntgenaufnahme in Linksseitenlage und Laboruntersuchungen (Blutbild, CRP, Serumelektrolyte, Blutgasanalyse mit Laktatbestimmung und eine mikrobiologische Blutkulturuntersuchung) reichen als diagnostische Maßnahmen meist aus. Die Einlage eines dicklumigen Darmrohrs zur Darmspülung, ausreichender Flüssigkeitsersatz, Antibiotikatherapie und Intensivbehandlung sind häufig geeignet, den Zustand des Kindes zu stabilisieren. Bessert sich der Allgemeinzustand nicht, sollte notfallmäßig ein Dünndarmstoma angelegt werden.

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Authors and Affiliations

  1. Universitäts-Kinderspital beider Basel, Basel, Schweiz

    Johannes Mayr

  2. Kinder- und Jugendchirurgie, Klinikum Klagenfurt, Klagenfurt am Wörthersee, Österreich

    Günter Fasching

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  1. Johannes Mayr
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  2. Günter Fasching
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Correspondence to Johannes Mayr .

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Editors and Affiliations

  1. Universitäts-Kinderspital beider Basel (UKBB), Basel, Switzerland

    Johannes Mayr

  2. Kinder- und Jugendchirurgie, Klinikum Klagenfurt, Klagenfurt am Wörthersee, Austria

    Günter Fasching

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Mayr, J., Fasching, G. (2018). Hirschsprung-assoziierte Enterokolitis . 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_14

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  • DOI: https://doi.org/10.1007/978-3-662-55995-6_14

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-55994-9

  • Online ISBN: 978-3-662-55995-6

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