Akute Bauchschmerzen können häufig einzelnen Organsystemen zugeordnet werden und müssen frühzeitig interdisziplinär von Internisten und Viszeralchirurgen versorgt werden. Ein Großteil der chronischen Bauchschmerzen ist durch organisch verursachte Störungen der Darm-Hirn-Achse bedingt. Eine verlässliche Differenzierung der Beschwerden ist z.B. bei Patienten mit Reizdarmsyndrom und gleichzeitiger Divertikelkrankheit Typ 3a klinisch nicht möglich.
Abstract
Acute abdominal pain may relate to specific organ systems and needs an interdisciplinary approach with close collaboration between internal and surgical disciplines. Main objective is to shorten the diagnostic work-up between the beginning of the symptoms and their therapy. After clarifying of the five w-questions: when, how, how long, why, and where, abdominal ultrasound, ECG, laboratory diagnostics and early application of computed tomography should be performed.
For the most part, chronic abdominal pain is caused by disorders of the gut-brain-axis such as the irritable bowel syndrome. Because of the synaptic plasticity, the processing of pain is dynamic and cannot be related to a single organ system. This problem is obvious in patients with irritable bowel syndrome and colonic diverticula, which may be interpreted as symptomatic uncomplicated diverticular disease (SUDD, type 3a). However, a reliable clinical differentiation between both groups is not possible. The establishment of SUDD (type 3a) considerable widened the application area of mesalazine.
Schlüsselwörter
akute Bauchschmerzen - chronische Bauchschmerzen - Reizdarmsyndrom - Divertikulose - symptomatische unkomplizierte Divertikelkrankheit
Keywords
acute abdominal pain - chronic abdominal pain - irritable bowel syndrome - diverticulosis - symptomatic uncomplicated diverticular disease
