Diagnostik bei chronisch entzündlichen Darmerkrankungen

Zusammenfassung

Trotz zahlreicher neuer diagnostischer Möglichkeiten wie beispielsweise dem MR-Enteroklysma oder der Kapselendoskopie stellen die gezielte Anamnese mit körperlicher Untersuchung sowie die Endoskopie mit makroskopischer und histologischer Beurteilung des Kolons und des terminalen Ileums nach wie vor die Grundpfeiler in der Erstdiagnose und Differenzialdiagnose chronisch entzündlicher Darmerkrankungen dar. Ein vollständiges Bild kann analog eines Puzzles nur aus den Ergebnissen der bildgebenden Verfahren sowie der Endoskopie und eventuell komplementär mit Hilfe einer gezielten Labor- bzw. mikrobiologischen Diagnostik zusammengesetzt werden. In der Anwendung des diagnostischen Armentariums sollte, um unnötige Untersuchungen zu vermeiden, immer zwischen Primärdiagnostik bei dem V. a. eine chronisch entzündliche Darmerkrankung und bei Sicherung der Diagnose dem „Staging” der Erkrankung, sowie der Verlaufsbeurteilung bei gesichertem M. Crohn oder gesicherter Colitis ulcerosa unterschieden werden.

Abstract

Despite numerous new diagnostic tools such as capsule endoscopy or MR-enteroclysis a careful patient history, a clinical examination and an ileocolonoscopy with macroscopical and histological evaluation represent still the foundation of the diagnosis and differential diagnosis of inflammatory bowel disease. Similar to a puzzle a complete picture of the disease can only be obtained, if the results of the radiological procedures, of the endoscopy and sometimes the complementary laboratory and/or microbiological analyses are put together. However, when choosing a diagnostic procedure or strategy in the daily clinical life, one should always distinguish between the primary diagnosis of inflammatory bowel disease and the staging of established Crohn's disease or ulcerative colitis.

Schlüsselwörter

Chronisch entzündliche Darmerkrankung - Morbus Crohn - Colitis ulcerosa - Diagnostik

Key words

Inflammatory bowel disease - Crohn's disease - ulcerative colitis - diagnosis

Literatur

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