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Indikationen zur chirurgischen Intervention und operative Strategie bei Divertikelblutung

  • Chapter
Divertikulose und Divertikelkrankheit

Zusammenfassung

Divertikelblutungen stellen neben Hämorrhoidalblutungen, Blutungen aus kolorektalen Karzinomen oder aus Gefäßmalformationen die häufigste Ursache unterer gastrointestinaler Blutungen dar. Divertikelblutungen sind in mehr als 80 % der Fälle selbstlimitierend und nur selten lebensbedrohlich. Notfalleingriffe aufgrund persistierender Divertikelblutungen sind eine Rarität. Im Notfall und ohne exakte Kenntnis des Blutungsortes kann eine Kolektomie mit Ileorektostomie oder endständigem Ileostoma indiziert sein. Elektive Segmentresektionen können nach exakter Lokalisation der Blutungsquelle mit geringem Risiko und heute meist minimalinvasiv durchgeführt werden. Daher ist die präoperative Lokalisationsdiagnostik für Risiko und Erfolg der Operation entscheidend.

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Literatur

  • Andersen JC, Bundgaard L, Elbrond H, et al. (2012) Danish national guidelines for treatment of diverticular disease. Dan Med J 59: C4453

    Google Scholar 

  • Bender JS, Wiencek RG, Bouwman DL (1991) Morbidity and mortality following total abdominal colectomy for massive lower gastrointestinal bleeding. Am Surg 57: 536–40; discussion 540–541

    Google Scholar 

  • Buttenschoen K, Buttenschoen DC, Odermath R, et al. (2001) Diverticular disease-associated hemorrhage in the elderly. Langenbecks Arch Surg 386: 8–16

    Google Scholar 

  • Chen CY, Wu CC, Jao SW, et al. (2009) Colonic diverticular bleeding with comorbid diseases may need elective colectomy. J Gastrointest Surg 13: 516–520

    Google Scholar 

  • Cirocchi R, Grassi V, Cavaliere D, et al. (2015) New Trends in Acute Management of Colonic Diverticular Bleeding: A Systematic Review. Medicine (Baltimore) 94: e1710

    Google Scholar 

  • Couto-Worner I, Gonzalez-Conde B, Estevez-Prieto E, et al. (2013) Colonic diverticular bleeding: urgent colonoscopy without purging and endoscopic treatment with epinephrine and hemoclips. Rev Esp Enferm Dig 105: 495–498

    Google Scholar 

  • Cuomo R, Barbara G, Pace F, et al. (2014) Italian consensus conference for colonic diverticulosis and diverticular disease. United European Gastroenterol J 2: 413–442

    Google Scholar 

  • Farner R, Lichliter W, Kuhn J, et al. (1999) Total colectomy versus limited colonic resection for acute lower gastrointestinal bleeding. Am J Surg 178: 587–591

    Google Scholar 

  • Field RJ, Sr., Field RJ, Jr., Shackleford S (1994) Total abdominal colectomy for control of massive lower gastrointestinal bleeding. J Miss State Med Assoc 35: 29–33

    Google Scholar 

  • Fujino Y, Inoue Y, Onodera M, et al. (2013) Risk factors for early re-bleeding and associated hospitalization in patients with colonic diverticular bleeding. Colorectal Dis 15: 982–986

    Google Scholar 

  • Green BT, Rockey DC, Portwood G, et al. (2005) Urgent colonoscopy for evaluation and management of acute lower gastrointestinal hemorrhage: a randomized controlled trial. Am J Gastroenterol 100: 2395–2402

    Google Scholar 

  • Heianna J, Miyauchi T, Yamano H, et al. (2014) Management of angiogram-negative acute colonic hemorrhage: safety and efficacy of colonoscopy-guided superselective embolization. Tech Coloproctol 18: 647–652

    Google Scholar 

  • Jansen A, Harenberg S, Grenda U, et al. (2009) Risk factors for colonic diverticular bleeding: a Westernized community based hospital study. World J Gastroenterol 15: 457–461

    Google Scholar 

  • Jensen DM, Machicado GA, Jutabha R, et al. (2000) Urgent colonoscopy for the diagnosis and treatment of severe diverticular hemorrhage. N Engl J Med 342: 78–82

    Google Scholar 

  • Klar E, Stowhas M, Foitzik T (2006) Chirurgische Therapiekonzepte bei unterer gastrointestinaler Blutung. Chirurg 77: 133–138

    Google Scholar 

  • Koelz HR, Arn M (2006) Neue Epidemiologie der akuten gastrointestinalen Blutung. Chirurg 77: 103–110

    Google Scholar 

  • Labenz J (2014) Divertikelblutung. Diagnostik, konservative Therapie, Opertionsindikation. Chirurg 85: 314–319

    Google Scholar 

  • Lee KK, Shah SM, Moser MA (2011) Risk factors predictive of severe diverticular hemorrhage. Int J Surg 9: 83–85

    Google Scholar 

  • Leifeld L, Germer CT, Bohm S, et al. (2014) S2k Leitlinie Divertikelerkrankung/Divertikulitis. Z Gastroenterol 52: 663–710

    Google Scholar 

  • Niikura R, Nagata N, Yamada A, et al. (2012) Recurrence of colonic diverticular bleeding and associated risk factors. Colorectal Dis 14: 302–305

    Google Scholar 

  • Poncet G, Heluwaert F, Voirin D, et al. (2010) Natural history of acute colonic diverticular bleeding: a prospective study in 133 consecutive patients. Aliment Pharmacol Ther 32: 466–471

    Google Scholar 

  • Renzulli P, Maurer CA, Netzer P, et al. (2002) Subtotal colectomy with primary ileorectostomy is effective for unlocalized, diverticular hemorrhage. Langenbecks Arch Surg 387: 67–71

    Google Scholar 

  • Schuetz A, Jauch KW (2001) Lower gastrointestinal bleeding: therapeutic strategies, surgical techniques and results. Langenbecks Arch Surg 386: 17–25

    Google Scholar 

  • Setya V, Singer JA, Minken SL (1992) Subtotal colectomy as a last resort for unrelenting, unlocalized, lower gastrointestinal hemorrhage: experience with 12 cases. Am Surg 58: 295–299

    Google Scholar 

  • Suh S, Seo PJ, Park H, et al. (2012) The risk factors for colonic diverticular bleeding. Korean J Gastroenterol 60: 349–354

    Google Scholar 

  • Suzman MS, Talmor M, Jennis R, et al. (1996) Accurate localization and surgical management of active lower gastrointestinal hemorrhage with technetium-labeled erythrocyte scintigraphy. Ann Surg 224: 29–36

    Google Scholar 

  • Tanaka Y, Motomura Y, Akahoshi K, et al. (2012) Predictive factors for colonic diverticular rebleeding: a retrospective analysis of the clinical and colonoscopic features of 111 patients. Gut Liver 6: 334–338

    Google Scholar 

  • Wheat CL, Strate LL (2015) Trends in Hospitalization for Diverticulitis and Diverticular Bleeding in the United States From 2000 to 2010. Clin Gastroenterol Hepatol 14: 96–103

    Google Scholar 

  • Wingen M, Gunther RW (2006) Gastrointestinale Blutung. Interventionell-radiologische Diagnostik und Therapie. Chirurg 77: 117–125

    Google Scholar 

  • Yamada A, Sugimoto T, Kondo S, et al. (2008) Assessment of the risk factors for colonic diverticular hemorrhage. Dis Colon Rectum 51: 116–120

    Google Scholar 

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Authors and Affiliations

  1. Zedernweg 16, 22605, Hamburg

    Prof. Dr. med. Wolfgang Schwenk

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  1. Prof. Dr. med. Wolfgang Schwenk
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Editors and Affiliations

  1. Universitätsklinikum Würzburg, Würzburg, Deutschland

    Christoph-Thomas Germer

  2. St. Bernward Krankenhaus, Hildesheim, Deutschland

    Ludger Leifeld

  3. Evangelisches Krankenhaus Kalk, Köln, Deutschland

    Wolfgang Kruis

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Schwenk, W. (2018). Indikationen zur chirurgischen Intervention und operative Strategie bei Divertikelblutung. In: Germer, CT., Leifeld, L., Kruis, W. (eds) Divertikulose und Divertikelkrankheit. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-53549-3_13

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  • DOI: https://doi.org/10.1007/978-3-662-53549-3_13

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-53548-6

  • Online ISBN: 978-3-662-53549-3

  • eBook Packages: Medicine (German Language)

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