Akutes Abdomen pp 389-396 | Cite as

Magen und Duodenum

  • Andreas Puntschart
  • Michael Sereinigg
  • Hubert Hauser

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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Copyright information

© Springer-Verlag Wien 2016

Authors and Affiliations

  • Andreas Puntschart
    • 1
  • Michael Sereinigg
    • 2
  • Hubert Hauser
    • 3
  1. 1.Klinische Abteilung für AllgemeinchirurgieMedizinische Universität GrazGraz
  2. 2.Klinische Abteilung für TransplantationschirurgieMedizinische Universität GrazGraz
  3. 3.Chirurgische Abteilung LKH Graz Süd-West, Standort WestGraz

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