Stenosis
A stenosis ( Greek στένωσις sténosis , German 'constriction' ) is a narrowing or narrowing (of the lumen) or constriction (narrowed point) of hollow organs (for example of blood vessels , the trachea or the ureter). Causes , symptoms , diagnosis and treatment depend on the localization and clinical findings . When stenosis is the process of contraction.
Stenosis of the blood vessels
Stenoses of the blood vessels are mostly caused by arteriosclerosis , but can also result from injuries or inflammation or be congenital.
With restenosis of the re-closure of the blood vessel is referred to after treatment. This is a common complication after the insertion of a stent , for example , when the body's own tissue grows into the vessel and thereby narrows it again.
In coronary heart disease (CHD), a stenosis often manifests itself in anginal symptoms. A stenosis is often the preliminary stage of an obstruction that then leads to an acute heart attack .
If there are stenoses in the arterial leg vessels, one speaks of peripheral arterial occlusive disease . There are also stenoses of the renal arteries ( renal artery stenosis ), the iliac vessels and the neck vessels ( carotid stenosis ). The latter pose a risk of cerebral infarction due to vascular occlusion or arterial embolism .
For diagnosis, sonography or stress echocardiography , digital subtraction angiography or coronary angiography , magnetic resonance angiography and computed tomography angiography are used.
Often, only drug treatment is indicated , in which blood pressure , triglycerides and cholesterol are lowered and anticoagulants are given. However, there are also indications in which stenoses are treated with angioplasty (with or without stenting ) or with a bypass . For the coronary vessels , these procedures are called PTCA (also balloon dilatation ) or coronary artery bypass .
Stenoses of the heart valves
As aortic stenosis which is congenital or acquired narrowing of the aortic valve , or (as in the aortic coarctation understood) of the outflow tract of the left ventricle. Stenoses also occur in other heart valves , especially in the area of the pulmonary valve ; the atrioventricular valves ( mitral valve and tricuspid valve ) are less often affected. During auscultation, stenoses are characterized by an increasing and decreasing heart murmur (crescendo- decrescendo type).
Further stenoses
- Esophageal stenosis (may be caused, for example, by esophageal atresia , carcinoma of the esophagus , carcinoma of the stomach in the pyloric antrum, or by cicatricial changes ).
- Gastric outlet obstruction (for example, comes in. Pylorus - hypertrophy or with a gastric carcinoma in the pyloric region of the stomach before).
- Intestinal stenosis, in extreme cases, intestinal obstruction (can occur, for example, in Crohn's disease , due to braids or radiation enteritis ).
- Bile duct stenosis (also called DHC stenosis; can occur, for example, as a scarring change after a gallstone disease, in the case of pancreatic carcinoma or in the case of bile duct carcinoma ).
- Tracheal stenosis (tracheal stenosis) or bronchus stenosis (bronchial). Can lead to dyspnea (shortness of breath) or atelectasis . B. in lung cancer or very large goiter of the thyroid gland.
- Ureteral stenosis (so-called ureteral stenosis or obstructive uropathy may, to a urinary lead).
- Spinal canal stenosis (as cauda equina syndrome , e.g. in the case of a herniated disc ).
- Stenosis of the foramina of the cerebral ventricles or the aqueduct ( aqueduct stenosis ) leads to hydrocephalus .
- Lymph vascular stenosis (eg in cancer or after operations. Can lead to lymphedema , in extreme cases to elephantiasis ).
- Annular ligament stenosis: See Snapping Finger .
See also
Individual evidence
- ↑ Duden: Narrowing .
- ↑ Duden: Narrowing .
- ^ JO Gebbers: Atherosclerosis, cholesterol, nutrition, and statins - a critical review GMS Ger Med Sci. 2007; 5; Doc04 egms.de .
- ↑ G. Herold: Internal Medicine. Herold-Verlag, Cologne 2009.
