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DOI: 10.1055/s-2000-6916
© Georg Thieme Verlag Stuttgart · New York
Peptische Ulkusblutung*
Publication History
Publication Date:
31 December 2000 (online)
![](https://www.thieme-connect.de/media/viszeralchirurgie/200004/lookinside/thumbnails/10.1055-s-2000-6916-1.jpg)
Einleitung
Die Blutung aus einem peptischen Ulkus ist nach wie vor ein lebensbedrohendes Krankheitsereignis mit einer generellen Todeswahrscheinlichkeit von etwa 10 %. In der zurückliegenden Dekade haben genauere Detailkenntnisse über die Blutungsquelle, klarere Vorstellungen zur Pathogenese der Ulkusblutung und Fortschritte auf dem weiten Feld endoskopischer Blutstillungstechniken die Chance einer Überlebensverbesserung gebracht. Basis für die Möglichkeit zur Risikominderung ist aber unverändert die Notfallendoskopie, deren prognostischer Informationsgehalt in die Behandlungsstrategie einfließen muss [1].
Die dennoch hohe Gesamt-Sterblichkeit der Ulkusblutung und eine Operationsletalität von bis zu 20 % machen die Bemühungen verständlich, mit neuen Therapieansätzen unter Einschluss endoskopischer Blutstillungsverfahren und kausal wirksamer Medikamente hier eine weitere Verbesserung zu erreichen. Dabei gilt es insbesondere, operationsbedürftige Blutungen per se oder nach initialer, endoskopisch erfolgreicher Blutstillung rechtzeitig zu identifizieren und von denjenigen abzugrenzen, die auch ohne Operation einen „benignen selbstbegrenzenden” Verlauf nehmen.
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Prof. Dr. med. Klaus Peter Thon
Abt. f. Allgemein-, Viszeral- und Unfallchirurgie
Robert-Bosch-Krankenhaus
Auerbachstr. 110
70376 Stuttgart