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DOI: 10.1055/s-2003-37334
Die eosinophile Kolitis - eine seltene Differenzialdiagnose des rechtsseitigen Unterbauchschmerzes
Eosinophilic Colitis - a Rare Differential Diagnosis of Right Lower Quadrant PainPublication History
Publication Date:
18 February 2003 (online)
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Zusammenfassung
Die eosinophile Kolitis ist eine seltene entzündliche Darmerkrankung unklarer Ätiologie, die dem Formenkreis der eosinophilen Gastrointestinopathien zuzuordnen ist. Ursächlich ist eine Darmwandinfiltration mit eosinophilen Granulozyten, die eine unspezifische Entzündungsreaktion unterschiedlichster Lokalisation, Ausdehnung und Morphe induziert. Es können pseudopolypöse Lumeneinengungen mit Ileussymptomatik, Darmwandintussuszeptionen oder Perforationen resultieren. Da häufig Zökum und Colon ascendens betroffen sind, ist der rechtsseitige Unterbauchschmerz das Kardinalsymptom der Erkrankung. Folglich wird die Diagnose zumeist nicht wünschenswerterweise endoskopisch-bioptisch gesichert, sondern unter der Verdachtsdiagnose einer akuten Appendizitis per explorativer Laparotomie erzwungen. Primär sind jedoch konservative Therapieansätze mit Absetzen fraglich auslösender Noxen oder Kortikosteroidapplikationen indiziert. Erst bei Beschwerdepersistenz muß der Resektionseingriff erfolgen.
Abstract
Eosinophilic Kolitis is a rare inflammatory bowel disease of unknown etiology, which must be classed with the group of eosinophilic gastrointestinopathies. It is caused by an infiltration of the intestinal wall by eosinophilic granulocytes which induces an unspecific inflammatory reaction of varying localisation, extent and morphe. Pseudopolypoid obstruction with ileussymptoms, intussusception of the bowel wall or perforation may occur. As cecum and ascending colon are frequently involved, right lower quadrant pain is the leading symptom of the disease. Therefore diagnosis is usually not made endoscopically, as is desirable, but by explorative laparotomy under suspicion of acute appendicitis. Nevertheless conservative therapeutic strategies with reduction of questionably noxious medication or the application of corticosteroids are primarily indicated. Only if symptoms persist, a bowel resection has to be performed.
Schlüsselwörter
Eosinophile Kolitis - rechtsseitiger Unterbauchschmerz - Resektionseingriff
Key words
Eosinophilic colitis - right lower quadrant pain - bowel resection
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