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Der Klinikarzt 2007; 36(10): 560-568
DOI: 10.1055/s-2007-993072
GI-Erkrankungen

© Georg Thieme Verlag Stuttgart · New York

Die mittlere gastrointestinale Blutung - Eine diagnostische und therapeutische Herausforderung

Obscure gastrointestinal bleeding - A diagnostic and therapeutic challengeDirk Hartmann1 , Jürgen F. Riemann1
  • 1Gastroenterologie, Hepatologie, Diabetologie, Medizinische Klinik C, Klinikum der Stadt Ludwigshafen gGmbH,Akademisches Lehrkrankenhaus der Johannes-Gutenberg-Universität Mainz(Direktor: Prof. Dr. J.F. Riemann)
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Publication History

Publication Date:
31 October 2007 (online)

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Seit der Einführung der Kapselendoskopie und wenig später der Doppelballonenteroskopie ist der Dünndarm nicht länger eine „Black box” in der endoskopischen Diagnostik. Insbesondere bei Patienten mit mittlerer gastrointestinaler Blutung haben die beiden Verfahren die Diagnostik revolutioniert. Weitere endoskopische Methoden in der Diagnostik einer mittleren gastrointestinalen Blutung sind die Push-Enteroskopie und die intraoperative Enteroskopie - Verfahren mit jeweils unterschiedlichen Techniken, die wiederum verschiedene Vor- und Nachteile bedingen. So scheint die Kapselendoskopie zum Beispiel für diagnostische Zwecke gut geeignet zu sein, insbesondere, wenn der Dünndarm in seiner gesamten Länge eingesehen werden muss. Ein großer Vorteil der Doppelballonenteroskopie dagegen ist, dass neben der Diagnostik gleich die Möglichkeit zum therapeutischen Eingriff besteht.

The small bowel ceased to be a „black box” in endoscopy diagnostics when capsule endoscopy and shortly thereafter double-balloon endoscopy were introduced. These two procedures revolutionised diagnostics especially in patients suffering from obscure gastrointestinal bleeding. Push enteroscopy and intraoperative endoscopy are further diagnostic methods in obscure gastrointestinal bleeding. Each of these methods is based on a different technique with different pros and cons. For example, capsule endoscopy appears well suited as a diagnostic procedure especially if the small bowel must be visible in its entire length. On the other hand, it is a great advantage of double-balloon endoscopy that it enables immediate therapeutic action besides diagnosing.

Key words

obscure gastrointestinal bleeding - capsule endoscopy - double-balloon enteroscopy - push enteroscopy - intraoperative endoscopy

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Korrespondenz

Prof. Jürgen F. Riemann

Medizinische Klinik C Klinikum der Stadt Ludwighafen gGmbH

Bremserstraße 79

67063 Ludwigshafen am Rhein

Email: riemannj@klilu.de

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