Summary
There is no doubt that patients with liver cirrhosis, large esophageal varices and extremely elevated intraesophageal variceal pressure have a high risk of variceal bleeding. Telangiectasias on the top of large varices, extremely elevated wedged hepatic venous pressure and a severe reduction of clotting factors are probable risk factors for a variceal hemorrhage, too. Several of these risk factors were analysed in a prospective controlled randomized trial. Endoscopic sclerosis was not only able to reduce the frequency of variceal bleeding but also to prolong life significantly. Thus the value of such risk factors for variceal hemorrhage in patients with liver cirrhosis is well established.
Zusammenfassung
Es gilt als sicher, daß Lebercirrhotiker mit ausgeprägten Oesophagusvaricen und deutlich erhöhtem Druck in diesen Krampfadern ein hohes Blutungsrisiko aufweisen. Als wahrscheinliche Risikofaktoren werden Teleangiektasien auf den Kuppen von großen Krampfadern, erhöhter Lebervenenverschlußdruck und schwere Synthesestörungen der Gerinnungsfaktoren angesehen. Mehrere dieser Risikofaktoren wurden in einer kontrollierten randomisierten Studie auf ihre Blutungsgefährdung überprüft. Durch prophylaktische Wandsklerosierung der Speiseröhre konnte nicht nur die Häufigkeit der Blutung bei solchen Risikopatienten vermindert, sondern deren Überlebenszeit signifikant verlängert werden. Damit ist der Wert dieser Risikofaktoren gesichert.
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Paquet, K.J. 6. Die Indikation zur prophylaktischen Sklerosierungsbehandlung von Oesophagusvaricen. Langenbecks Arch Chiv 369, 69–74 (1986). https://doi.org/10.1007/BF01274323
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DOI: https://doi.org/10.1007/BF01274323