Intestinal Ultrasound in Rare Gastrointestinal Diseases, Update, Part 1

Zusammenfassung

Die Sonografie des Darmes hat sich als Methode zur Diagnostik chronisch entzündlicher Darmerkrankungen, der Divertikulitis, der Appendizitis, des Ileus, der Perforation und der Invagination sowie anderer akuter Darmerkrankungen etabliert. Auf seltene Darmerkrankungen wird hingegen nur eher kasuistisch in der Literatur Bezug genommen. Sonografisch werden die Wandstrukturen, Darminhalt und die Motilität, Stenosen und Ileuszustände ebenso erfasst wie der transmurale Aspekt mit Randreaktionen, Fisteln oder Abszessbildungen. Gelegentlich ist die Sonografie dabei bereits diagnostisch; wesentlich häufiger kann die Anwendung des intestinalen Ultraschalls entscheidende Hilfen geben, um invasivere und aufwändigere Methoden zu vermeiden. Zweifellos kann die Methode sehr gut zum „Follow-up“ entzündlicher Erkrankungen genutzt werden. Den durch sonografische Untersuchung bei der Abklärung seltener gastrointestinaler Erkrankungen erzielbaren diagnostischen Informationen kommt bei adäquater Untersuchungstechnik ein ähnlich hoher Stellenwert zu wie in der Differenzialdiagnostik von Leberherden. Diese aus zwei Teilen bestehende Arbeit beleuchtet aus der Erfahrung sonografischer Kompetenzzentren die Rolle des Ultraschalls bei seltenen Darmerkrankungen, über die bisher wenig publiziert ist. Der erste Teil fokussiert auf die Untersuchungstechnik, entzündliche Erkrankungen des Magen-Darm-Trakts und Zöliakie und der zweite Teile auf angeborene Erkrankungen, speziell auch chirurgisch relevante Krankheitsbilder, neoplastische und Gefäßerkrankungen sowie Varia.

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