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Endoskopie heute 2014; 27(2): 101-105
DOI: 10.1055/s-0034-1366685
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

GAVE und portal-hypertensive Gastropathie

GAVE and Portal-Hypertensive Gastropathy
M. Sackmann
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Publication History

Publication Date:
24 July 2014 (online)

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Zusammenfassung

GAVE-Syndrom (gastric antral vascular ectasia, Wassermelonenmagen) und portal-hypertensive Gastropathie (PHG) stellen unterschiedliche Erkrankungen dar, deren Ätiologie und Pathogenese noch unvollständig erforscht sind. Beide weisen ein charakteristisches endoskopisches Bild auf. GAVE und PHG können asymptomatisch sein, führen aber häufig zu chronischem, selten auch zu akutem Blutverlust. Sie sind mit portaler Hypertension assoziiert (GAVE) bzw. kausal verbunden (PHG). Dementsprechend unterscheiden sich auch die Therapiemöglichkeiten. Insbesondere für das GAVE-Syndrom wurden in letzter Zeit als Alternative zur bewährten Argonplasmakoagulation die Multibandligatur und die Radiofrequenzablation erprobt. Bei der akuten PHG-Blutung könnte ein Hämospray eine therapeutische Option als Brücke bis zum Wirkeintritt der klassischen nicht selektiven Betablockerbehandlung darstellen.

Abstract

Gastric antral vascular ectasia (GAVE, watermelon stomach) and portal-hypertensive gastropathy (PHG) represent two distinct entities. The etiology and the pathogenesis of GAVE and PHG are not fully understood. The primary symptom of GAVE and PHG is anemia due to chronic bleeding. GAVE is associated with portal hypertension, but may also occur in patients with various other conditions. PHG is almost exclusively observed in patients with portal hypertension. Traditionally, GAVE is treated with argon plasma coagulation. Recently, multiband ligation and radiofrequency ablation have been added to the therapeutic options in GAVE. PHG is usually treated by non-selective beta-blockers. A hemospray might be an alternative for acute bleeding.

Schlüsselwörter

GAVE-Syndrom - Wassermelonenmagen - portal-hypertensive Gastropathie

Key words

gastric antral vascular ectasia, GAVE - watermelon stomach - portal hypertensive gastropathy
 

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