Wilhelm T J, Post S
Chirurgische Klinik, Universitätsklinikum Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland.
Chirurg. 2018 Mar;89(3):197-204. doi: 10.1007/s00104-017-0584-z.
The increasing number of refugees, migrants and international travelers influences the surgical spectrum of abdominal diseases. The aim of this review is to familiarize surgeons with specific diseases which are endemic in the patients' countries of origin and are likely to be diagnosed with increasing incidence in Germany. Low levels of hygiene in the countries of origin or refugee camps is associated with a high incidence of numerous infections, such as helminth infections, typhoid fever or amoebiasis, which if untreated can cause surgical emergencies. Historically, some of them were common in Germany but have been more or less eradicated because of the high socioeconomic standard. Echinococcosis and Chagas disease are frequently treated surgically while schistosomiasis can mimic intestinal cancer. Abdominal tuberculosis presents in a variety of abdominal pathologies and frequently causes diagnostic uncertainty. Sigmoid volvulus has a very low incidence among Europeans, but is one of the most common abdominal surgical conditions of adults in endemic countries. The number of patients who eventually undergo surgery for these conditions might be relatively low; however, surgeons must be aware of them and consider them as differential diagnoses in refugees and migrants with acute or chronic abdominal symptoms.
难民、移民和国际旅行者数量的不断增加影响了腹部疾病的外科治疗范围。本综述的目的是让外科医生熟悉患者原籍国的地方病,这些疾病在德国的诊断发病率可能会增加。原籍国或难民营的卫生水平低下与多种感染的高发病率相关,如蠕虫感染、伤寒或阿米巴病,如果不治疗,这些感染可能会引发外科急症。从历史上看,其中一些疾病在德国很常见,但由于社会经济水平较高,或多或少已被根除。棘球蚴病和恰加斯病经常需要手术治疗,而血吸虫病可能会误诊为肠癌。腹部结核表现为多种腹部病变,常导致诊断不确定。乙状结肠扭转在欧洲人中发病率极低,但在地方病流行国家却是成人最常见的腹部外科疾病之一。最终因这些疾病接受手术的患者数量可能相对较少;然而,外科医生必须了解这些疾病,并将其作为有急性或慢性腹部症状的难民和移民的鉴别诊断。