Ätiologie, Pathogenese und Morphologie des Morbus Crohn

Zusammenfassung.

Der Morbus Crohn ist eine chronische Entzündung, die alle Abschnitte des Gastrointestinaltraktes betreffen kann. Am häufigsten sind jedoch das terminale Ileum und/oder der Dickdarm befallen. Der (granulomatöse) Entzündungsprozeß ist diskontinuierlich, disproportional und häufig über alle Darmwandschichten (transmural) ausgebreitet. Die Erkrankung führt zu einer Reihe von intestinalen und extraintestinalen Komplikationen. Der Morbus Crohn wird heute als eine Allgemeinerkrankung mit intestinalem Schwerpunkt aufgefaßt. Die Ätiologie und Pathogenese des Morbus Crohn ist nach wie vor ungeklärt. Die heutige Arbeitshypothese ist, daß es bei genetischer Prädisposition und durch bestimmte Faktoren ausgelöst (u. a. Ernährung? Bakterien?) zu einer fehlerhaften Immunantwort (mangelhafter anti-inflammatorischer Prozeß?) des Darms mit Manifestation des Krankheitbildes „Morbus Crohn” kommt. Der folgende Übersichtsartikel beschreibt den heutigen Kenntnisstand bezüglich Ätiologie, Immunologie, Epidemiologie sowie dem makro- und mikroskopischen Erscheinungsbild des Morbus Crohn einschließlich seiner Differentialdiagnose zur Colitis ulcerosa.

Crohn's disease is a chronic inflammatory disorder which may involve any segment of the gastrointestinal tract, although the disease most commonly affects the terminal ileum and/or the colon. The (granulomatous) inflammatory process is discontinuous, disproportional and shows typically transmural involvement of all layers of the bowel wall. The disease may lead to a variety of intestinal and extra-intestinal complications. Although primarily an enteric disorder, Crohn's disease appears to be systemic in distribution. Its etiology and pathogenesis still remains unclear. This review deals with our present knowledge about etiology, immunology, epidemiology, and the macroscopical and microscopical appearence of Crohn's disease including its differential diagnosis to ulcerative colitis.

Schlüsselwörter:

Morbus Crohn - Ätiologie - Pathogenes - Krebsentstehung

Key words:

Crohn's disease - Etiology - Pathogenesis - Cancer development

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