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Die Gastroenterologie

Erschienen in:

07.04.2021 | Varikosis | Schwerpunkt

Portale Hypertension und Varizen

verfasst von: J. Kluwe, Univ.-Prof. Dr. Alexander Zipprich

Erschienen in: Die Gastroenterologie | Ausgabe 3/2021

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Zusammenfassung

Die portale Hypertension ist für prognoselimitierende Komplikationen einer Leberzirrhose verantwortlich. Die Varizenblutung stellt die zweithäufigste Komplikation dar und ist mit einer weiterhin hohen Mortalität verbunden. Dabei kann ein frühzeitiges Screening auf klinisch signifikante portale Hypertension und gastroösophageale Varizen die rechtzeitige Etablierung primärprophylaktischer Maßnahmen erlauben. Die Behandlung der akuten Varizenblutung erfolgt nach einer multimodalen Strategie aus medikamentöser Senkung des portalen Hypertonus, prophylaktischer Antibiose, restriktiver Transfusionstherapie und endoskopischer Blutstillung. Nach durchgemachter Blutung verhindert die frühe, präemptive Implantation eines transjugulären intrahepatischen portosystemischen Shunts (TIPS) innerhalb von 72 h bei ausgewählten Patienten mit fortgeschrittener Leberzirrhose Rezidivblutungen und reduziert die Mortalität. Patienten, bei denen kein TIPS angelegt wurde, sollten eine medikamentös-endoskopische Sekundärprophylaxe erhalten. Diese Übersichtsarbeit fasst die aktuellen Konzepte zu Diagnostik der portalen Hypertension und zur Prävention und Behandlung der Varizenblutung zusammen.

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Titel: Portale Hypertension und Varizen
verfasst von: J. Kluwe
Univ.-Prof. Dr. Alexander Zipprich
Publikationsdatum: 07.04.2021
Verlag: Springer Medizin
Schlagwörter: Varikosis
Arterielle Hypertonie
Leberzirrhose
Varikosis
Ösophagusvarizen
Antibiotika
Varikosis
Portale Hypertonie
Portale Hypertonie
Erschienen in: Die Gastroenterologie / Ausgabe 3/2021
Print ISSN: 2731-7420
Elektronische ISSN: 2731-7439
DOI: https://doi.org/10.1007/s11377-021-00516-4

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Portale Hypertension und Varizen

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