Gastrointestinale Blutungen

Gastrointestinale Blutungen sind häufig und können anhand der Anamnese und mithilfe klinischer und laborchemischer Untersuchungen schnell diagnostiziert werden. Die weitere Behandlung sollte dann endoskopisch unter stationären Bedingungen erfolgen. Dieser CME-Artikel gibt eine detaillierte Übersicht zum klinischen Management und stellt verschiedene endoskopische Vorgehensweisen in Abhängigkeit von der Blutungslokalisation vor.

Abstract

Gastrointestinal bleeding Gastrointestinal bleeding occurs frequently in clinical practice. The presence of gastrointestinal bleeding usually is suspected by typical clinical history and results of clinical examination and laboratory findings. Endoscopic treatment of gastrointestinal bleeding is associated with high success rates over 90%. Different techniques for endoscopic hemostasis are available and for most indications, a combination of two modalities is recommended. Endoscopic management of recurrent or persistent bleeding is technically more challenging and associated with increased mortality (up to 10%, especially in patients with high age and comorbidities). In this situation, endoscopic hemostasis using an over-the-scope clip has shown to be superior to standard treatment for recurrent peptic ulcer bleeding in the upper gastrointestinal tract. Recent studies also have shown superiority for first-line over-the-scope clip treatment of non-variceal upper gastrointestinal bleeding in high-risk patients. In this review, management of gastrointestinal bleeding is summarized based on current guidelines and current literature.

Kernaussagen

• Das Auftreten gastrointestinaler Blutungen ist im klinischen Alltag häufig.

• Das Management gastrointestinaler Blutungen erfolgt endoskopisch unter stationären Bedingungen.

• Die Spiral-Enteroskopie ist ein neues Verfahren zur endoskopischen Intervention im Dünndarm.

• Der OTSC ist den Standardclips bei der Rezidiv-Ulkusblutung im oberen GI-Trakt überlegen.

• Die variköse obere Gastrointestinalblutung muss früh von der nicht varikösen Blutung abgegrenzt werden.

• Beim Management gastrointestinaler Blutungen kann ein interdisziplinäres Vorgehen erforderlich sein.

Schlüsselwörter

gastrointestinal - Blutung - endoskopisch - Management - Clip

Keywords

gastrointestinal - bleeding - endoscopic - management - clip

Publication History

Article published online:
23 January 2023

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