{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T23:55:34Z","timestamp":1767138934722,"version":"build-2238731810"},"reference-count":56,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2021,2,25]],"date-time":"2021-02-25T00:00:00Z","timestamp":1614211200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,2,25]],"date-time":"2021-02-25T00:00:00Z","timestamp":1614211200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Hamburg-Eppendorf (UKE)"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Chirurg"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Hintergrund<\/jats:title>\n                    <jats:p>Patienten mit einer Querschnittl\u00e4hmung entwickeln syndromspezifische, viszeralchirurgisch relevante Krankheitsbilder, die im Rahmen des akuten spinalen Schocks auftreten k\u00f6nnen oder Folge der zumeist progredienten neurogenen Darmfunktionsst\u00f6rung (NBD) mit Ausbildung eines Colon elongatum und\/oder Megakolons sind. Auch die akuten abdominalchirurgischen Notf\u00e4lle, wie akute Appendizitis, Cholezystitis, Divertikultis oder Ileusbilder, stellen den Kliniker bei untypischer oder teils fehlender Klinik vor diagnostische und therapeutische Herausforderungen. Einen zunehmenden Stellenwert nimmt die Ausweitung adipositaschirurgischer Indikationen auf Patienten mit einer Querschnittl\u00e4hmung ein<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ziel der Arbeit<\/jats:title>\n                    <jats:p>Dieser Artikel soll einen \u00dcberblick \u00fcber die speziellen Anforderungen und Aspekte in der Behandlung dieses speziellen Patientenkollektivs geben und die Evidenz querschnittspezifischer viszeralchirurgischer Behandlungen aufzeigen.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material und Methoden<\/jats:title>\n                    <jats:p>Es wurde eine selektive Literaturrecherche in den Datenbanken Medline und Cochrane Library in deutscher und englischer Sprache (1985\u20132020) durchgef\u00fchrt.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ergebnisse und Diskussion<\/jats:title>\n                    <jats:p>Die klinische Behandlung querschnittgel\u00e4hmter Patienten erfordert einen profunden Kenntnisstand \u00fcber die pathophysiologischen Ver\u00e4nderungen bei unterschiedlicher Querschnitth\u00f6he (oberes vs. unteres motorisches Neuron) und die Phasen der Erkrankung (spinaler Schock vs. Langzeitverlauf). Fehlende oder atypische klinische Symptome akuter Erkrankungen verz\u00f6gern eine rasche Diagnosefindung und machen eine fr\u00fchzeitige Durchf\u00fchrung gezielter Diagnostik unabdingbar. Die Evidenz der chirurgischen Behandlung der akuten und chronischen Folgen der NBD ist gering und basiert auf Fallserien und \u201ecase reports\u201c ebenso wie die f\u00fcr spezielle Indikationen wie adipositaschirurgische Eingriffe.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00104-021-01364-2","type":"journal-article","created":{"date-parts":[[2021,2,25]],"date-time":"2021-02-25T05:03:39Z","timestamp":1614229419000},"page":"551-558","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Der querschnittgel\u00e4hmte Patient\u00a0\u2013 Besonderheiten der viszeralchirurgischen Diagnostik und Therapie","The paraplegic patient\u2014Characteristics of diagnostics and treatment in visceral surgery"],"prefix":"10.1007","volume":"92","author":[{"given":"Julia","family":"Seifert","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ralf","family":"B\u00f6thig","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Wolter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jakob R.","family":"Izbicki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roland","family":"Thietje","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Tachezy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,2,25]]},"reference":[{"key":"1364_CR1","first-page":"704","volume":"33","author":"Z Bar-On","year":"1995","unstructured":"Bar-On\u00a0Z, Ohry\u00a0A (1995) The acute abdomen in spinal cord injury individuals. 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