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Endoskopische Therapie der unteren gastrointestinalen Blutung

Endoscopic management of lower gastrointestinal bleeding

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Zusammenfassung

Das Erreichen einer stabilen Hämostase ist das Ziel der interventionellen Endoskopie. Die Notfallkoloskopie ist aufgrund des diagnostischen und therapeutischen Potenzials die Methode der ersten Wahl. Die Untersuchung sollte nach Vorbereitung mit 4–6 l Polyethylenglykollösung innerhalb von 12 h durchgeführt werden. Bei unvorbereitetem Darm ist die Koloskopie im Fall einer massiven hämodynamisch wirksamen Blutung z. B. unter Verwendung einer Spülpumpe ohne erhöhte Komplikationsrate möglich. Zahlreiche endoskopische Blutstillungsmethoden (Injektionstherapie, mechanische Blutstillung, thermische und topische Verfahren) stehen zur Verfügung. Je nach Blutungsquelle muss die geeignete Blutstillungsmethode für den Einzelfall gewählt werden.

Abstract

Endoscopic hemostasis is the daily challenge that must be mastered by gastroenterologists. An emergency colonoscopy is the procedure of choice for lower gastrointestinal bleeding because of the diagnostic and therapeutic potential. Colonoscopy should be performed after oral preparation with 4–6 l polyethylene glycol solution within 12 h. In the case of massive hematochezia, colonoscopy without oral preparation employinga mechanical pump is possible and is not associated with a higher rate of complications. Many different endoscopic techniques are available (injection therapy, hemoclips, thermal coagulation, topical hemostatic substances). The suitable and most effective method must be chosen depending on the source of bleeding.

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Authors and Affiliations

  1. III. Medizinische Klinik, Klinikum Augsburg, Stenglinstr. 2, 81656, Augsburg, Deutschland

    A. Meier,  H. Messmann &  S.K. Gölder

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  1. A. Meier
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  2. H. Messmann
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  3. S.K. Gölder
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Correspondence to A. Meier.

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A. Meier, H. Messmann und S.K. Gölder geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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M. Buerke, Siegen

H. Messmann, Augsburg

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Meier, A., Messmann, H. & Gölder, S. Endoskopische Therapie der unteren gastrointestinalen Blutung. Med Klin Intensivmed Notfmed 110, 515–520 (2015). https://doi.org/10.1007/s00063-015-0077-0

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  • DOI: https://doi.org/10.1007/s00063-015-0077-0

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