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Erschienen in: Der Internist 7/2011

01.07.2011 | Schwerpunkt

Intensivmedizin und chronisch entzündliche Darmerkrankungen (CED)

Schwerer und fulminanter Schub

verfasst von: PD Dr. J. Büning, K. Fellermann

Erschienen in: Die Innere Medizin | Ausgabe 7/2011

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Zusammenfassung

Chronisch entzündliche Darmerkrankungen sind trotz aller Bemühungen nicht heilbar. Auch wenn es für die Colitis ulcerosa eine definitive chirurgische Behandlungsmöglichkeit zu geben scheint, sind die Patienten sowohl durch eine Entzündung des neu geschaffenen Reservoirs, die Pouchitis, als auch durch peri- und postoperative Komplikationen bedroht. Beim M. Crohn können wir derzeit durch medikamentöse Therapiestrategien eine notwendige Operation hinausschieben, eine definitive Heilung liegt jedoch in weiter Ferne. Die medikamentösen Therapien setzen die Patienten bei aller Wirksamkeit zudem einem potenziell lebensbedrohlichen Risiko aus. Gerade der schwerkranke Patient bedarf einer genauen Beobachtung und entsprechend maßvollen Therapie, die von Gastroenterologen und Chirurgen getragen werden muss. Nach wie vor zielt die konservative Therapie auf eine Unterdrückung erworbener Immunmechanismen und stellt damit keinen kausalen Ansatz dar. Nichtsdestotrotz ist es auf diese Weise gelungen, Operationsnotwendigkeit und Krankenhausaufenthalte zu reduzieren. Die Möglichkeiten und Besonderheiten dieser Strategien für den schweren und fulminanten Schub werden aufgezeigt.
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Metadaten
Titel
Intensivmedizin und chronisch entzündliche Darmerkrankungen (CED)
Schwerer und fulminanter Schub
verfasst von
PD Dr. J. Büning
K. Fellermann
Publikationsdatum
01.07.2011
Verlag
Springer-Verlag
Erschienen in
Die Innere Medizin / Ausgabe 7/2011
Print ISSN: 2731-7080
Elektronische ISSN: 2731-7099
DOI
https://doi.org/10.1007/s00108-010-2797-9

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