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Gastroenterologie up2date 2020; 16(01): 23-37
DOI: 10.1055/a-0920-4168
Wichtige Methoden in der Gastroenterologie
Georg Thieme Verlag KG Stuttgart · New York

Innovative endoskopische Dünndarmdiagnostik: gestern, heute und morgen

Andrea Tal
,
Jörg Albert
,
Johannes Hausmann
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Publication History

Publication Date:
10 March 2020 (online)

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Innovative endoskopische Verfahren haben in den letzten 20 Jahren einen enormen Fortschritt in der endoskopischen Dünndarmdiagnostik bewirkt: Nicht nur die Visualisierung des kompletten Dünndarms, auch umfassende therapeutische Interventionen sind möglich geworden. Dieser Beitrag beschreibt die diagnostischen und therapeutischen Optionen dieser innovativen endoskopischen Modalitäten und stellt ihre Anwendungsmöglichkeiten dar.
Kernaussagen

  • Die endoskopische Untersuchung des Dünndarms ist als Routineverfahren etabliert.

  • Neben den Dünndarmkapselendoskopen sind die ballongestützten Enteroskopietechniken weitverbreitet.

  • Das Kapselendoskop wird durch die natürliche Peristaltik durch den Dünndarm bewegt. Die Ballonenteroskope werden durch das „Push-and-Pull“-Manöver vorangebracht und die Spiralenteroskope mittels Drehbewegung eines auf das Endoskop aufgesetzten Tubus.

  • Eine endoskopische Abklärung des Dünndarms sollte nach negativer ÖGD und Koloskopie bei eindeutigen klinischen Hinweisen auf einen intestinalen Blutverlust in aller Regel erfolgen. Hierzu kann aus Gründen der Praktikabilität primär die Kapselendoskopie herangezogen werden.

  • Neben der symptomorientierten Indikation zur Dünndarmendoskopie kommen zunehmend auch Indikationen zur Untersuchung bei bekannten Diagnosen wie dem Morbus Crohn und dem Peutz-Jeghers-Syndrom hinzu.

Dünndarm - Enteroskopie - Doppelballon - Kapselendoskopie - Spiralenteroskopie
 

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