Acta chirurgica Austriaca

, Volume 25, Issue 3, pp 149–151 | Cite as

Endoskopische Abklärung von Ösophagusvarizen

  • G. Fischer
  • G. Kleber
  • T. Sauerbruch
Themenschwerpunkt: Neue Trends in der Therapie der Portalen Hypertonie Diagnostik
  • 12 Downloads

Zusammenfassung

Die Endoskopie von Ösophagusvarizen spielt eine herausragende Rolle in der Abklärung und Betreuung von Patienten mit portaler Hypertension. Alle Patienten mit einer portalen Hypertension, für die beim Nachweis von Varizen eine Behandlung mit z. B. einem Beta-Blocker in Frage kommt, sollten endoskopiert werden, wobei Zahl, Größe, longitudinale Ausdehnung sowie Oberflächenmerkmale allfälliger Varizen detailliert beschrieben werden müssen. Darüber hinaus sind Zeichen der portalen Hypertension, die sich im Magen manifestieren (Magen- und insbesondere Fundusvarizen, hypertensive Gastropathie, peptische Läsionen), zu dokumentieren.

Zeichen eines erhöhten Blutungsrisikos sind große Varizen, das “red-color-sign” der Varizenoberfläche und gleichzeitig bestehende Fundusvarizen. Hat der Patient zum Zeitpunkt der ersten Untersuchung kleine Varizen, empfehlen sich zur Dokumentation und Reevaluierung des Blutungsrisikos jährliche Kontrollen, bestehen (noch) keine Varizen, kann das Intervall auf alle 2 Jahre ausgedehnt werden.

Prospektive Studien zur Pathophysiologie der Varizenblutung und Untersuchungen von Medikamentenwirkungen an den Varizen sind mit endoskopischen Verfahren zur Blutdruckbestimmung inzwischen möglich geworden und werden Kenntnisse und Behandlungsmöglichkeiten der Erkrankung vertiefen.

Schlüsselwörter

Ösophagusvarizen Endoskopie Risikofaktoren der Varizenblutung Varizendruckmessung 

Endoscopy for the evaluation of esophageal varices

Summary

Endoscopy of esophageal varices is a main issue in the workup and care of patients with portal hypertension. They should be investigated endoscopically, if they are assigned and eligible to be treated with e.g. beta-blockers. Varices must be described regarding number, size, extension in the esophageus and presence or absence of surface markings. Signs of portal hypertension occurring in the stomach (gastric and fundic varices, hypertensive gastropathy, peptic lesions) should be recorded additionally. Signs of an increased bleeding risk are large varices, a “red color sign” or concomitant fundic varices. A yearly endoscopic assessment of the bleeding risk is recommended if varices are small. If there are none, endoscopy should be repeated every 2 years. Endoscopic variceal pressure measurements will increase the knowledge about the natural history and pathophysiology of variceal hemorrhage. The method is especially suitable for investigations of drug effects on variceal hemodynamics.

Key-words

Esophageal varices endoscopy riskfactors of variceal bleeding variceal pressure measurement 

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Copyright information

© Blackwell Scientific Publications Ltd 1992

Authors and Affiliations

  • G. Fischer
    • 1
  • G. Kleber
    • 1
  • T. Sauerbruch
    • 1
  1. 1.Medizinische Klinik IIKlinikum GroßhadernMünchenDeutschland

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