Zusammenfassung
Insgesamt ist die Ösophagusperforation ein seltenes Ereignis, welches allerdings
mit einer relativ hohen Mortalität vergesellschaftet ist. Entscheidend für ein gutes
Outcome sind neben den Defekteigenschaften und den patienteneigenen Risikofaktoren
der Zeitpunkt der Diagnosestellung und das zeitnahe Handeln. Unsere Beobachtungen
decken sich mit den veröffentlichten Daten, dass bei frühzeitiger Diagnosestellung
ein endoskopisches Vorgehen und konservatives Behandeln in ausgesuchten Fällen erfolgversprechend
ist. Sollte eine chirurgische Therapie notwendig werden, so ist der kleinstmögliche
Eingriff, z. B. als Übernähung, zu bevorzugen. Eine Resektion mit häufig dann notwendiger
zweizeitiger Rekonstruktion ist die Ultima ratio.
Abstract
Oesophageal perforation is commonly a rare diagnosis which is associated with a high
mortality rate. Decisive for a good clinical outcome are localisation and depth of
the perforation, risk factors, the time until diagnosis and a rapid therapy. The data
we collected agree with those in the published papers. In cases of an early diagnosis
sometimes an endoscopic therapy is possible. In cases of surgical therapy the smallest
intervention is the most favourable. A resection with the necessity for a later
reconstruction is considered as the ultima ratio.
Schlüsselwörter
Ösophagusruptur - interventionelle Endoskopie - Ösophagusresektion - Boerhaave-Syndrom
Key words
oesophageal rupture - interventional endoscopy - oesophageal resection - Boerhaave
syndrome
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Dr. Achim Troja
Klinik für Allgemein- und Visceralchirurgie · Klinikum Oldenburg gGmbH
Rahel-Strauss-Str. 10
26133 Oldenburg
Deutschland
Telefon: 04 41 / 4 03 22 54
eMail: achimtroja@hotmail.com
