Skip to main content
Erschienen in: Langenbeck's Archives of Surgery 6/2005

01.11.2005 | Current Concepts in Clinical Surgery

Standards of medical treatment and nutrition in Crohn’s disease

verfasst von: Britta Siegmund, Martin Zeitz

Erschienen in: Langenbeck's Archives of Surgery | Ausgabe 6/2005

Einloggen, um Zugang zu erhalten

Abstract

Crohn’s disease is a condition of chronic inflammation potentially involving any location of the alimentary tract from mouth to anus but with a propensity for the distal small bowel and proximal large bowel. Frequent complications include stricture and fistula. Numerous extra-intestinal manifestations may also be present. The aetiology of Crohn’s disease is incompletely understood, and therapy, although generally effective in alleviating the symptoms, is not curative. Due to the heterogeneity of the disease a major need for the therapeutic approach is the ability to define subgroups with distinct characteristics. However, with regard to the heterogeneity of demographic, anatomic and disease behaviour characteristics, distilling the numerous possible phenotypes in simple categories is a formidable task. In the present review the focus will be on clinically relevant situations providing therapeutic algorithms according to international guidelines.
Literatur
1.
Zurück zum Zitat Fiocchi C (1998) Inflammatory bowel disease: etiology and pathogenesis. Gastroenterology 115:182–205PubMed Fiocchi C (1998) Inflammatory bowel disease: etiology and pathogenesis. Gastroenterology 115:182–205PubMed
2.
Zurück zum Zitat Gasche C, Schölmerich J, Brynskov J, D’Haens G, Hanauer SB, Irvine EJ, et al (2000) A simple classification of Crohn’s disease: report of Working Party for the World Congress of Gastroenterology, Vienna 1998. Inflamm Bowel Dis 6:8–15PubMed Gasche C, Schölmerich J, Brynskov J, D’Haens G, Hanauer SB, Irvine EJ, et al (2000) A simple classification of Crohn’s disease: report of Working Party for the World Congress of Gastroenterology, Vienna 1998. Inflamm Bowel Dis 6:8–15PubMed
3.
Zurück zum Zitat Modigliani R, Mary JY, Simon JF, Cortot A, Soule JC, Gendre JP, et al (1990) Clinical, biological, and endoscopic picture of attacks of Crohn’s disease. Evolution on prednisolone. Groupe d’Etude Therapeutique des Affections Inflammatoires Digestives. Gastroenterology 98:811–818PubMed Modigliani R, Mary JY, Simon JF, Cortot A, Soule JC, Gendre JP, et al (1990) Clinical, biological, and endoscopic picture of attacks of Crohn’s disease. Evolution on prednisolone. Groupe d’Etude Therapeutique des Affections Inflammatoires Digestives. Gastroenterology 98:811–818PubMed
4.
Zurück zum Zitat Greenberg GR, Feagan BG, Martin F, Sutherland LR, Thomson AB, Williams CN, et al (1994) Oral budesonide for active Crohn’s disease. Canadian Inflammatory Bowel Disease Study Group. N Engl J Med 331:836–841CrossRefPubMed Greenberg GR, Feagan BG, Martin F, Sutherland LR, Thomson AB, Williams CN, et al (1994) Oral budesonide for active Crohn’s disease. Canadian Inflammatory Bowel Disease Study Group. N Engl J Med 331:836–841CrossRefPubMed
5.
Zurück zum Zitat Greenberg GR, Feagan BG, Martin F, Sutherland LR, Thomson AB, Williams CN, et al (1996) Oral budesonide for active Crohn’s disease: a placebo-controlled, dose-ranging study. Canadian Inflammatory Bowel Disease Study Group. Gastroenterology 110:45–51PubMed Greenberg GR, Feagan BG, Martin F, Sutherland LR, Thomson AB, Williams CN, et al (1996) Oral budesonide for active Crohn’s disease: a placebo-controlled, dose-ranging study. Canadian Inflammatory Bowel Disease Study Group. Gastroenterology 110:45–51PubMed
6.
Zurück zum Zitat Thomsen OO, Cortot A, Jewell D, Wright JP, Winter T, Veloso FT, et al (1998) A comparison of budesonide and mesalamine for active Crohn’s disease. International Budesonide/Mesalamine Study Group. N Engl J Med 339:370–374CrossRefPubMed Thomsen OO, Cortot A, Jewell D, Wright JP, Winter T, Veloso FT, et al (1998) A comparison of budesonide and mesalamine for active Crohn’s disease. International Budesonide/Mesalamine Study Group. N Engl J Med 339:370–374CrossRefPubMed
7.
Zurück zum Zitat Rutgeerts P, Lofberg R, Malchow H, Lamers C, Olaison G, Jewell D, et al (1994) A comparison of budesonide with prednisolone for active Crohn’s disease. N Engl J Med 331:842–845CrossRefPubMed Rutgeerts P, Lofberg R, Malchow H, Lamers C, Olaison G, Jewell D, et al (1994) A comparison of budesonide with prednisolone for active Crohn’s disease. N Engl J Med 331:842–845CrossRefPubMed
8.
9.
Zurück zum Zitat Landi B, Anh TN, Cortot A, Soule JC, Rene E, Gendre JP, et al (1992) Endoscopic monitoring of Crohn’s disease treatment: a prospective, randomized clinical trial. The Groupe d’Etudes Therapeutiques des Affections Inflammatoires Digestives. Gastroenterology 102:1647–1653PubMed Landi B, Anh TN, Cortot A, Soule JC, Rene E, Gendre JP, et al (1992) Endoscopic monitoring of Crohn’s disease treatment: a prospective, randomized clinical trial. The Groupe d’Etudes Therapeutiques des Affections Inflammatoires Digestives. Gastroenterology 102:1647–1653PubMed
10.
Zurück zum Zitat Malchow H, Ewe K, Brandes JW, Goebell H, Ehms H, Sommer H, et al (1984) European Cooperative Crohn’s Disease Study (ECCDS): results of drug treatment. Gastroenterology 86:249–266PubMed Malchow H, Ewe K, Brandes JW, Goebell H, Ehms H, Sommer H, et al (1984) European Cooperative Crohn’s Disease Study (ECCDS): results of drug treatment. Gastroenterology 86:249–266PubMed
11.
Zurück zum Zitat Ewe K, Press AG, Singe CC, Stufler M, Ueberschaer B, Hommel G, et al (1993) Azathioprine combined with prednisone or monotherapy with prednisolone in active Crohn’s disease. Gastroenterology 105:367–372PubMed Ewe K, Press AG, Singe CC, Stufler M, Ueberschaer B, Hommel G, et al (1993) Azathioprine combined with prednisone or monotherapy with prednisolone in active Crohn’s disease. Gastroenterology 105:367–372PubMed
12.
Zurück zum Zitat Keane J, Gershon S, Wise RP, Mirabile-Levens E, Kasznica J, Schwieterman WD, et al (2001) Tuberculosis associated with infliximab, a tumor necrosis factor alpha-neutralizing agent. N Engl J Med 345:1098–1104CrossRefPubMed Keane J, Gershon S, Wise RP, Mirabile-Levens E, Kasznica J, Schwieterman WD, et al (2001) Tuberculosis associated with infliximab, a tumor necrosis factor alpha-neutralizing agent. N Engl J Med 345:1098–1104CrossRefPubMed
13.
Zurück zum Zitat Camma C, Giunta M, Rosselli M, Cottone M, Sandborn W, Sutherland L, et al (1997) Mesalamine in the maintenance treatment of Crohn’s disease: a meta-analysis adjusted for confounding variables. Gastroenterology 113:1465–1473PubMed Camma C, Giunta M, Rosselli M, Cottone M, Sandborn W, Sutherland L, et al (1997) Mesalamine in the maintenance treatment of Crohn’s disease: a meta-analysis adjusted for confounding variables. Gastroenterology 113:1465–1473PubMed
14.
Zurück zum Zitat Cottone M, Camma C, Fellermann K, Steffen M, Stein J, Raedler A, et al (2000) Mesalamine and relapse prevention in Crohn’s disease. Gastroenterology 119:597PubMed Cottone M, Camma C, Fellermann K, Steffen M, Stein J, Raedler A, et al (2000) Mesalamine and relapse prevention in Crohn’s disease. Gastroenterology 119:597PubMed
15.
Zurück zum Zitat Sandborn W, Sutherland L, Pearson D, May G, Modigliani R, Prantera C, et al (2000) Azathioprine or 6-mercaptopurine for inducing remission of Crohn’s disease. Cochrane Database Syst Rev 2:CD000545PubMed Sandborn W, Sutherland L, Pearson D, May G, Modigliani R, Prantera C, et al (2000) Azathioprine or 6-mercaptopurine for inducing remission of Crohn’s disease. Cochrane Database Syst Rev 2:CD000545PubMed
16.
Zurück zum Zitat Pearson DC, May GR, Fick G, Sutherland LR, Ortiz Z, Shea B, et al (2000) Azathioprine for maintaining remission of Crohn’s disease. Cochrane Database Syst Rev 342:CD000067 Pearson DC, May GR, Fick G, Sutherland LR, Ortiz Z, Shea B, et al (2000) Azathioprine for maintaining remission of Crohn’s disease. Cochrane Database Syst Rev 342:CD000067
17.
Zurück zum Zitat Boulton-Jones JR, Pritchard K, Mahmoud AA, Hanauer SB, McDonald JW, Ortiz Z, et al (2000) The use of 6-mercaptopurine in patients with inflammatory bowel disease after failure of azathioprine therapy. Aliment Pharmacol Ther 14:1561–1565CrossRefPubMed Boulton-Jones JR, Pritchard K, Mahmoud AA, Hanauer SB, McDonald JW, Ortiz Z, et al (2000) The use of 6-mercaptopurine in patients with inflammatory bowel disease after failure of azathioprine therapy. Aliment Pharmacol Ther 14:1561–1565CrossRefPubMed
18.
Zurück zum Zitat Bouhnik Y, Lemann M, Mary JY, Scemama G, Tai R, Matuchansky C, et al (1996) Long-term follow-up of patients with Crohn’s disease treated with azathioprine or 6-mercaptopurine. Lancet 347:215–219CrossRefPubMed Bouhnik Y, Lemann M, Mary JY, Scemama G, Tai R, Matuchansky C, et al (1996) Long-term follow-up of patients with Crohn’s disease treated with azathioprine or 6-mercaptopurine. Lancet 347:215–219CrossRefPubMed
19.
Zurück zum Zitat Feagan BG, Fedorak RN, Irvine EJ, Wild G, Sutherland L, Steinhart AH, et al (2000) A comparison of methotrexate with placebo for the maintenance of remission in Crohn’s disease. North American Crohn’s Study Group Investigators. N Engl J Med 342:1627–1632CrossRefPubMed Feagan BG, Fedorak RN, Irvine EJ, Wild G, Sutherland L, Steinhart AH, et al (2000) A comparison of methotrexate with placebo for the maintenance of remission in Crohn’s disease. North American Crohn’s Study Group Investigators. N Engl J Med 342:1627–1632CrossRefPubMed
20.
Zurück zum Zitat Ortiz Z, Shea B, Suarez Almazor M, Moher D, Wells G, Tugwell P (2000) Folic acid and folinic acid for reducing side effects in patients receiving methotrexate for rheumatoid arthritis. Cochrane Database Syst Rev 2:CD000951PubMed Ortiz Z, Shea B, Suarez Almazor M, Moher D, Wells G, Tugwell P (2000) Folic acid and folinic acid for reducing side effects in patients receiving methotrexate for rheumatoid arthritis. Cochrane Database Syst Rev 2:CD000951PubMed
21.
Zurück zum Zitat Neurath MF, Wanitschke R, Peters M, Krummenauer F, Meyer zum Buschenfelde KH, Schlaak JF (1999) Randomised trial of mycophenolate mofetil versus azathioprine for treatment of chronic active Crohn’s disease. Gut 44:625–628PubMed Neurath MF, Wanitschke R, Peters M, Krummenauer F, Meyer zum Buschenfelde KH, Schlaak JF (1999) Randomised trial of mycophenolate mofetil versus azathioprine for treatment of chronic active Crohn’s disease. Gut 44:625–628PubMed
22.
Zurück zum Zitat Fellermann K, Steffen M, Stein J, Raedler A, Hamling J, Ludwig D, et al (2000) Mycophenolate mofetil: lack of efficacy in chronic active inflammatory bowel disease. Aliment Pharmacol Ther 14:171–176CrossRefPubMed Fellermann K, Steffen M, Stein J, Raedler A, Hamling J, Ludwig D, et al (2000) Mycophenolate mofetil: lack of efficacy in chronic active inflammatory bowel disease. Aliment Pharmacol Ther 14:171–176CrossRefPubMed
23.
Zurück zum Zitat Hassard PV, Vasiliauskas EA, Kam LY, Targan SR, Abreu MT (2000) Efficacy of mycophenolate mofetil in patients failing 6-mercaptopurine or azathioprine therapy for Crohn’s disease. Inflamm Bowel Dis 6:16–20PubMed Hassard PV, Vasiliauskas EA, Kam LY, Targan SR, Abreu MT (2000) Efficacy of mycophenolate mofetil in patients failing 6-mercaptopurine or azathioprine therapy for Crohn’s disease. Inflamm Bowel Dis 6:16–20PubMed
24.
Zurück zum Zitat Schreiber S, Campieri M, Colombel JF, van Deventer SJ, Feagan B, Fedorak R, et al (2001) Use of anti-tumour necrosis factor agents in inflammatory bowel disease. European guidelines for 2001–2003. Int J Colorectal Dis 16:1–11CrossRefPubMed Schreiber S, Campieri M, Colombel JF, van Deventer SJ, Feagan B, Fedorak R, et al (2001) Use of anti-tumour necrosis factor agents in inflammatory bowel disease. European guidelines for 2001–2003. Int J Colorectal Dis 16:1–11CrossRefPubMed
25.
Zurück zum Zitat Hanauer SB, Feagan BG, Lichtenstein GR, Mayer LF, Schreiber S, Colombel JF, et al (2002) Maintenance infliximab for Crohn’s disease: the ACCENT I randomised trial. Lancet 359:1541–1549CrossRefPubMed Hanauer SB, Feagan BG, Lichtenstein GR, Mayer LF, Schreiber S, Colombel JF, et al (2002) Maintenance infliximab for Crohn’s disease: the ACCENT I randomised trial. Lancet 359:1541–1549CrossRefPubMed
26.
Zurück zum Zitat Aberra FN, Lewis JD, Hass D, Rombeau JL, Osborne B, Lichtenstein GR (2003) Corticosteroids and immunomodulators: postoperative infectious complication risk in inflammatory bowel disease patients. Gastroenterology 125:320–327CrossRefPubMed Aberra FN, Lewis JD, Hass D, Rombeau JL, Osborne B, Lichtenstein GR (2003) Corticosteroids and immunomodulators: postoperative infectious complication risk in inflammatory bowel disease patients. Gastroenterology 125:320–327CrossRefPubMed
27.
Zurück zum Zitat Schwartz DA, Wiersema MJ, Dudiak KM, Fletcher JG, Clain JE, Tremaine WJ, et al (2001) A comparison of endoscopic ultrasound, magnetic resonance imaging, and exam under anesthesia for evaluation of Crohn’s perianal fistulas. Gastroenterology 121:1064–1072PubMed Schwartz DA, Wiersema MJ, Dudiak KM, Fletcher JG, Clain JE, Tremaine WJ, et al (2001) A comparison of endoscopic ultrasound, magnetic resonance imaging, and exam under anesthesia for evaluation of Crohn’s perianal fistulas. Gastroenterology 121:1064–1072PubMed
28.
Zurück zum Zitat Schneider MU, Laudage G, Guggenmoos-Holzmann I, Riemann JF, Sutherland LR (1985) Metronidazole in the treatment of Crohn disease. Results of a controlled randomized prospective study. Dtsch Med Wochenschr 110:1724–1730PubMed Schneider MU, Laudage G, Guggenmoos-Holzmann I, Riemann JF, Sutherland LR (1985) Metronidazole in the treatment of Crohn disease. Results of a controlled randomized prospective study. Dtsch Med Wochenschr 110:1724–1730PubMed
29.
Zurück zum Zitat Pearson DC, May GR, Fick GH, Sutherland LR (1995) Azathioprine and 6-mercaptopurine in Crohn disease. A meta-analysis. Ann Intern Med 123:132–142PubMed Pearson DC, May GR, Fick GH, Sutherland LR (1995) Azathioprine and 6-mercaptopurine in Crohn disease. A meta-analysis. Ann Intern Med 123:132–142PubMed
30.
Zurück zum Zitat Present DH, Rutgeerts P, Targan S, Hanauer SB, Mayer L, van Hogezand RA, et al (1999) Infliximab for the treatment of fistulas in patients with Crohn’s disease. N Engl J Med 340:1398–1405CrossRefPubMed Present DH, Rutgeerts P, Targan S, Hanauer SB, Mayer L, van Hogezand RA, et al (1999) Infliximab for the treatment of fistulas in patients with Crohn’s disease. N Engl J Med 340:1398–1405CrossRefPubMed
31.
Zurück zum Zitat Veloso FT, Carvalho J, Magro F (1996) Immune-related systemic manifestations of inflammatory bowel disease. A prospective study of 792 patients. J Clin Gastroenterol 23:29–34CrossRefPubMed Veloso FT, Carvalho J, Magro F (1996) Immune-related systemic manifestations of inflammatory bowel disease. A prospective study of 792 patients. J Clin Gastroenterol 23:29–34CrossRefPubMed
32.
Zurück zum Zitat Felder JB, Korelitz BI, Rajapakse R, Schwarz S, Horatagis AP, Gleim G, et al (2000) Effects of nonsteroidal antiinflammatory drugs on inflammatory bowel disease: a case–control study. Am J Gastroenterol 95:1949–1954PubMed Felder JB, Korelitz BI, Rajapakse R, Schwarz S, Horatagis AP, Gleim G, et al (2000) Effects of nonsteroidal antiinflammatory drugs on inflammatory bowel disease: a case–control study. Am J Gastroenterol 95:1949–1954PubMed
33.
Zurück zum Zitat Felder JB, Korelitz BI, Rajapakse R, Schwarz S, Horatagis AP, Gleim G, et al (2002) Guidelines for the management of rheumatoid arthritis: 2002 update. Arthritis Rheum 46:328–346CrossRefPubMed Felder JB, Korelitz BI, Rajapakse R, Schwarz S, Horatagis AP, Gleim G, et al (2002) Guidelines for the management of rheumatoid arthritis: 2002 update. Arthritis Rheum 46:328–346CrossRefPubMed
34.
Zurück zum Zitat Braun J, Brandt J, Listing J, Zink A, Alten R, Golder W, et al (2002) Treatment of active ankylosing spondylitis with infliximab: a randomised controlled multicentre trial. Lancet 359:1187–1193CrossRefPubMed Braun J, Brandt J, Listing J, Zink A, Alten R, Golder W, et al (2002) Treatment of active ankylosing spondylitis with infliximab: a randomised controlled multicentre trial. Lancet 359:1187–1193CrossRefPubMed
35.
Zurück zum Zitat Tromm A, May D, Almus E, Voigt E, Greving I, Schwegler U, et al (2001) Cutaneous manifestations in inflammatory bowel disease. Z Gastroenterol 39:137–144CrossRefPubMed Tromm A, May D, Almus E, Voigt E, Greving I, Schwegler U, et al (2001) Cutaneous manifestations in inflammatory bowel disease. Z Gastroenterol 39:137–144CrossRefPubMed
36.
Zurück zum Zitat Parlak E, Kosar Y, Ulker A, Dagli U, Alkim C, Sahin B, et al (2001) Primary sclerosing cholangitis in patients with inflammatory bowel disease in Turkey. J Clin Gastroenterol 33:299–301CrossRefPubMed Parlak E, Kosar Y, Ulker A, Dagli U, Alkim C, Sahin B, et al (2001) Primary sclerosing cholangitis in patients with inflammatory bowel disease in Turkey. J Clin Gastroenterol 33:299–301CrossRefPubMed
37.
Zurück zum Zitat Zachos M, Tondeur M, Griffiths AM (2001) Enteral nutritional therapy for inducing remission of Crohn’s disease. Cochrane Database Syst Rev 3:CD000542PubMed Zachos M, Tondeur M, Griffiths AM (2001) Enteral nutritional therapy for inducing remission of Crohn’s disease. Cochrane Database Syst Rev 3:CD000542PubMed
38.
Zurück zum Zitat Heuschkel RB (2000) Enteral nutrition in children with Crohn’s disease. J Pediatr Gastroenterol Nutr 31:575CrossRefPubMed Heuschkel RB (2000) Enteral nutrition in children with Crohn’s disease. J Pediatr Gastroenterol Nutr 31:575CrossRefPubMed
39.
Zurück zum Zitat Goh J, O’Morain CA (2003) Review article: nutrition and adult inflammatory bowel disease. Aliment Pharmacol Ther 17:307–320CrossRefPubMed Goh J, O’Morain CA (2003) Review article: nutrition and adult inflammatory bowel disease. Aliment Pharmacol Ther 17:307–320CrossRefPubMed
40.
Zurück zum Zitat Clements D, Compston JE, Evans WD, Rhodes J (1993) Hormone replacement therapy prevents bone loss in patients with inflammatory bowel disease. Gut 34:1543–1546PubMed Clements D, Compston JE, Evans WD, Rhodes J (1993) Hormone replacement therapy prevents bone loss in patients with inflammatory bowel disease. Gut 34:1543–1546PubMed
41.
Zurück zum Zitat Homik J, Suarez-Almazor ME, Shea B, Cranney A, Wells G, Tugwell P (2000) Calcium and vitamin D for corticosteroid-induced osteoporosis. Cochrane Database Syst Rev 2:CD000952PubMed Homik J, Suarez-Almazor ME, Shea B, Cranney A, Wells G, Tugwell P (2000) Calcium and vitamin D for corticosteroid-induced osteoporosis. Cochrane Database Syst Rev 2:CD000952PubMed
42.
Zurück zum Zitat Homik J, Cranney A, Shea B, Tugwell P, Wells G, Adachi R, et al (2000) Biphosphonates for steroid induced osteoporosis. Cochrane Database Syst Rev 2:CD001347PubMed Homik J, Cranney A, Shea B, Tugwell P, Wells G, Adachi R, et al (2000) Biphosphonates for steroid induced osteoporosis. Cochrane Database Syst Rev 2:CD001347PubMed
43.
Zurück zum Zitat von Tirpitz C, Klaus J, Bruckel J, Rieber A, Scholer A, Adler G, et al (2000) Increase of bone mineral density with sodium fluoride in patients with Crohn’s disease. Eur J Gastroenterol Hepatol 12:19–24PubMed von Tirpitz C, Klaus J, Bruckel J, Rieber A, Scholer A, Adler G, et al (2000) Increase of bone mineral density with sodium fluoride in patients with Crohn’s disease. Eur J Gastroenterol Hepatol 12:19–24PubMed
Metadaten
Titel
Standards of medical treatment and nutrition in Crohn’s disease
verfasst von
Britta Siegmund
Martin Zeitz
Publikationsdatum
01.11.2005
Erschienen in
Langenbeck's Archives of Surgery / Ausgabe 6/2005
Print ISSN: 1435-2443
Elektronische ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-004-0498-3

Weitere Artikel der Ausgabe 6/2005

Langenbeck's Archives of Surgery 6/2005 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.