Zusammenfassung
Die Appendizitis ist die häufigste Ursache für ein akutes Abdomen. Jährlich werden ca. 135 000 Patienten in Deutschland appendektomiert. Die akute Appendizitis zeigt Veränderungen in der Epidemiologie, der Diagnostik und der Therapie. Die Epidemiologie weist eine weiter anhaltende rückläufige Inzidenz für die akute nicht perforierte Appendizitis auf. Die Inzidenz der perforierten Appendizitis ist trotz Laparoskopie und bildgebender Diagnostik konstant geblieben. In der Diagnostik nimmt der Stellenwert der Sonografie und Computertomografie weiter zu. Es zeigen sich jedoch Differenzen zwischen der Sensitivität und Spezifität der Untersuchungen in Studien und der klinischen Routine. Die Zunahme der bildgebenden Diagnostik korreliert nicht mit einer Abnahme der perforierten Appendizitis. Die laparoskopische Appendektomie entwickelt sich zum dominierenden Verfahren in der operativen Therapie. Die höhere Rate intraabdomineller Abzesse nach laparoskopischer Appendektomie bei perforierter Appendizitis ist nicht mehr nachzuweisen. Der Stapler wird zur Appendixstumpfversorgung am häufigsten genutzt.
Abstract
Appendicitis is the most common cause of an acute abdomen. Around 135 000 patients undergo appendectomy in Germany every year. Acute appendicitis shows changes in epidemiology, diagnosis and therapy. Epidemiological data indicate a continuing decrease in the incidence of acute non-perforated appendicitis. The incidence of perforated appendicitis has remained constant despite laparoscopy and imaging diagnostics. The status of sonography and CT scanning is increasing in the diagnosis of appendicitis. But there are differences between the sensitivity and specifity of study results and the clinical routine. The increase of imaging diagnostics does not correlate with a decrease in the incidence of perforated appendicitis. Laparoscopic appendectomy has developed as a dominant method for operative therapy. There is no proof of a higher rate of postoperative intraabdominal abscesses any more. The use of a stapler is mostly required for appendical stump closure.
Schlüsselwörter
akute Appendizitis - Epidemiologie - Appendektomie - Diagnostik
Key words
acute appendicitis - epidemiology - appendectomy - diagnosis
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Dr. M. Sahm
DRK Kliniken Berlin|Köpenick · Klinik für Chirurgie
Salvador-Allende-Str. 2–8
12559 Berlin
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Fax: 0 30 / 30 35 33 28
eMail: m.sahm@drk-kliniken-berlin.de
