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2020 | OriginalPaper | Buchkapitel

72. Chronische intestinale Ischämie

verfasst von : Young Erben, Gustavo S. Oderich, Eike Sebastian Debus

Erschienen in: Operative und interventionelle Gefäßmedizin

Verlag: Springer Berlin Heidelberg

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Zusammenfassung

Der häufigste Grund für eine chronische mesenteriale Ischämie (CMI) ist die Arteriosklerose, welche für mehr als 90 % der Fälle verantwortlich ist. Die arteriosklerotischen Läsionen betreffen meist den Ursprung oder die proximalen 2–3 cm der Mesenterialarterien, häufig in Verbindung mit einem Plaque in der Aorta und der Nierenarterien. Die Häufigkeit der mesenterialen Arteriosklerose reicht in Autopsiestudien von 6–10 %; bei Patienten, die einer Koronarangiografie oder aortalen Angiografie unterzogen wurden, steigt die Prävalenz auf 14–24 % an. Bildgebende Untersuchungen zeigen typischerweise in mehreren Gefäßterritorien Stigmata der Atherosklerose. Nicht-arteriosklerotische Läsionen können ebenfalls die Mesenterialarterien betreffen. Diese Patienten sind meist jünger. Die Vielfalt der diagnostischen Möglichkeiten bedarf einer intensiven Untersuchung, auch nach Vaskulitiden systemischem Lupus erythematodes, Morbus Winiwarter-Buerger, spontanen Dissektionen, fibromuskulärer Dysplasie, Neurofibromatose, Strahlungsarteriitis, Stenosen oder Okklusionen der Mesenterialvenen und medikamenteninduzierter Arteriopathien durch Kokain oder Mutterkornkonsum. Isthmusstenosen der Aorta abdominalis oder das „Mid Aortic Syndrom“ (Kap. „Gefäßmedizin bei Kindern und Heranwachsenden“) können ebenfalls Symptome einer mesenterialen Ischämie verursachen.

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Titel: Chronische intestinale Ischämie
verfasst von: Young Erben
Gustavo S. Oderich
Eike Sebastian Debus
Verlag: Springer Berlin Heidelberg
Buch: Operative und interventionelle Gefäßmedizin
Print ISBN: 978-3-662-53378-9

Electronic ISBN: 978-3-662-53380-2

Copyright-Jahr: 2020
DOI: https://doi.org/10.1007/978-3-662-53380-2_79

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