Endoskopische Blutstillungstechniken – Puder, Spray und Bärenkralle

Die gastrointestinale Blutung (overt oder okkult) ist ein häufiges Krankheitsbild in der täglichen klinischen Praxis. Dabei treten Symptome entsprechend der Blutungslokalisation auf. Die overte Blutung ist charakterisiert durch Teerstuhl, Hämatemesis oder Hämatochezie.

Okkulte gastrointestinale Blutungen fallen in Zufallsbefunden durch Anämie im Labor oder positive Stuhltests auf. Neben einer notfall- und intensivmedizinischen Versorgung bei der akuten Blutung spielt die gastrointestinale Endoskopie die wichtigste Rolle bei Diagnostik und Therapie der gastrointestinalen Blutung. Neue technische Entwicklungen haben in den letzten Jahren zu einer deutlichen Verbesserung der interventionell endoskopischen Versorgung dieser Patienten geführt. So sind neben Injektionsverfahren, auch mechanische und thermische Anwendungen weiterentwickelt worden, um die Effektivität der Blutstillung zu verbessern. Diese neuen Verfahren werden im Rahmen dieses Reviews vorgestellt.

Gastrointestinal bleeding (occult or overst) is still a common disease in daily clinical practice. Common symptoms for acute bleeding are melena, hematemesis and hematochezia. However, occult gastrointestinal bleeding fall into incidental findings by anemia or positive stool tests. Beside of emergency care and intensive medical care gastrointestinal endoscopy plays the most important role in diagnosis and therapy of gastrointestinal bleedings. In recent years the technical development has led to a significant improvement in the interventional endoscopic management of these bleedings. Thus, mechanical and thermal applications, in addition to injection procedure, has been developed in order to optimize endoscopic hemostasis. This review deals with these new endoscopic techniques.

Key words

Gastrointestinal bleeding - endoscopy - hemoclip - injection procedure - hemospray

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