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Akute mesenteriale Ischämie

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Operative und interventionelle Gefäßmedizin

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Zusammenfassung

Die arterielle Perfusion des Gastrointestinaltraktes erfolgt durch den Truncus coeliacus sowie die Arteria mesenterica superior und inferior. Der Truncus coeliacus (TC) versorgt neben Magen und Duodenum die Milz und das hepatobiliäre System. Die Arteria mesenterica superior (AMS) speist das Jejunum, Ileum sowie Colon ascendens und transversum. Die Arteria mesenterica inferior versorgt den Bereich vom Colon transversum bis zum Rektum. Robuste Kollateralen zwischen den 3 Hauptgefäßen (Arteria pancreaticoduodenalis superior und inferior, Riolan-Arkade), können dazu führen, dass langsam sich entwickelnde Stenosen oder Verschlüsse eines oder zwei der Hauptarterien asymptomatisch bleiben (Abb. 1). Die plötzliche Okklusion eines der 3 mesenterialen Hauptäste ohne vorherige Ausbildung eines kollateralen Netzwerkes verursacht hingegen schwere Darmischämien. Die akute mesenteriale Ischämie (AMI) ist ein chirurgischer Notfall mit einer gut dokumentierten hohen Mortalitätsrate innerhalb des Krankenhauses zwischen 59 % und 94 % (Kassahun et al. 2008). Pathophysiologisch liegen der AMI eine arterielle Embolie, eine arterielle Thrombose, eine nicht-okkludierende mesenteriale Ischämie (NOMI) oder eine mesenteriale Venenthrombose zugrunde. Der Fokus dieses Kapitels liegt auf der Behandlung der AMI.

Der Herausgeber Eike Sebastian Debus hat diesen Beitrag übersetzt und freigegeben

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Author information

Authors and Affiliations

  1. Vascular and Endovascular Surgery, Yale School of Medicine, New Haven, USA

    Young Erben

  2. Mayo Clinic, Rochester, USA

    Gustavo S. Oderich

  3. Klinik und Poliklinik für Gefäßmedizin, Universitäres Herz- und Gefäßzentrum Hamburg, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland

    Eike Sebastian Debus

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  1. Young Erben
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  2. Gustavo S. Oderich
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  3. Eike Sebastian Debus
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Correspondence to Eike Sebastian Debus .

Editor information

Editors and Affiliations

  1. Klinik und Poliklinik für Gefäßmedizin Gefäßchirurgie – Angiologie – endovaskuläre Therapie, Universitätsklinikum Hamburg-Eppendorf Universitäres Herz- und Gefäßzentrum, Hamburg, Germany

    Eike Sebastian Debus

  2. Abteilung für Diagnostische und Interventionelle Radiologie, Asklepios Klinikum Harburg, Hamburg, Germany

    Walter Gross-Fengels

Section Editor information

  1. Klinik und Poliklinik für Gefäßmedizin, Universitäres Herzzentrum Hamburg, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland

    Eike Sebastian Debus

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Erben, Y., Oderich, G.S., Debus, E.S. (2020). Akute mesenteriale Ischämie. In: Debus, E., Gross-Fengels, W. (eds) Operative und interventionelle Gefäßmedizin. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-53380-2_78

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  • DOI: https://doi.org/10.1007/978-3-662-53380-2_78

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