Zeitschrift fur Gastroenterologie最新文献

{"title":"Perisplenic mass as initial diagnosis of malignant peritoneal mesothelioma.","authors":"Christoph Petrynowski, Albrecht Neesse, Volker Ellenrieder, Philipp Ströbel, Ahmad Amanzada, Golo Petzold","doi":"10.1055/a-2622-2136","DOIUrl":"https://doi.org/10.1055/a-2622-2136","url":null,"abstract":"<p><p>Perisplenic masses or collections are rare findings on imaging examinations. The differential diagnostic spectrum is broad. We report the case of an 84-year-old man who presented to our emergency department with fatigue, unwanted weight loss, loss of appetite and abdominal pain. In B-mode ultrasound a very hypoechoic collection circularly located around the spleen was seen. A splenic hematoma or an abscess were primarily suspected. Performing contrast-enhanced ultrasound examination the perisplenic collection was surprisingly strongly contrasted in the arterial phase. An additional abdominal CT confirmed the mass in the left upper abdomen circularly around the spleen, compressing the left colic flexure and beginning to infiltrate the gastric fundus. An ultrasound-guided tissue biopsy was taken via a percutaneous intercostal approach, which resulted in the diagnosis of a low-grade epithelioid malignant peritoneal mesothelioma (MPM). MPM often presents with diffuse multifocal involvement of the peritoneal lining, however a unifocal manifestation of MPM is uncommon in general. A perisplenic mass manifestation of malignant peritoneal mesothelioma is an extremely rare occurrence. This case highlights the diagnostic challenges posed by the rare perisplenic manifestation of MPM.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From guidelines to evidence-based practice - A German perspective on mesalazine as first-line therapy for mild-to-moderate ulcerative colitis.","authors":"Elisabeth Schnoy, Axel Dignass, Matthew Gaskins, Torsten Kucharzik","doi":"10.1055/a-2596-8934","DOIUrl":"https://doi.org/10.1055/a-2596-8934","url":null,"abstract":"<p><p>Mesalazine is the first-line treatment for mild-to-moderate ulcerative colitis (UC) of any extent, as recommended by all major international and national guidelines. Approximately 85% of UC cases are classified as mild-to-moderate, making mesalazine a cornerstone therapy for the majority of patients. It rapidly induces clinical response and clinical remission, sustains steroid-free clinical, endoscopic, and histologic remission over the long term, and has a safety profile comparable to placebo. This paper reviews the recommendations for mesalazine use in the German UC guideline and provides practical advice (including do's and don'ts) for their implementation in daily clinical practice. Examples include explaining the expected timeline and nature of the clinical response to mesalazine treatment; outlining the practical implications of the dose-dependency of the drug's therapeutic effect; and emphasizing the importance of rectal mesalazine as the first-line treatment for proctitis. Additionally, we conducted a systematic literature search to evaluate whether mesalazine should be continued after escalation to biologics or small molecules. While no clear evidence of short-term clinical benefit was found, there was also no evidence of harm. In light of the potential long-term chemoprotective effect of mesalazine, continuation may be considered on a case-by-case basis. Lastly, we provide an overview of the various mesalazine formulations available in Germany, detailing how they are not interchangeable due to differences in drug-release profiles, excipients, and dosing strengths. Understanding these differences may help clinicians personalize treatment, improving adherence and clinical outcomes.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In memoriam: John S. Fordtran (1931-2025) Honorary Member of the Austrian Society of Gastroenterology and Hepatology.","authors":"","doi":"10.1055/a-2602-7792","DOIUrl":"https://doi.org/10.1055/a-2602-7792","url":null,"abstract":"","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":"63 6","pages":"689"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Guideline report of the updated S3 guideline \"Rare liver diseases (LeiSe LebEr) - Autoimmune liver diseases from paediatrics to adulthood\" of the German Society of Gastroenterology, Digestive and Metabolic Diseases (DGVS)].","authors":"Nadine Fischer, Paul Freudenberger, Ansgar W Lohse, Pia Lorenz, Petra Lynen Jansen, Marcial Sebode, Nadine Steubesand","doi":"10.1055/a-2558-5300","DOIUrl":"https://doi.org/10.1055/a-2558-5300","url":null,"abstract":"","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":"63 6","pages":"366-388"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[S3 guideline \"Rare liver diseases (LeiSe LebEr) - Autoimmune liver diseases from paediatrics to adulthood\" of the German Society of Gastroenterology, Digestive and Metabolic Diseases (DGVS)].","authors":"","doi":"10.1055/a-2558-5204","DOIUrl":"https://doi.org/10.1055/a-2558-5204","url":null,"abstract":"","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":"63 6","pages":"604-688"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Evidence-based guidelines in gastroenterological medical care: a survey among members of the German Society for Gastroenterology, Digestive and Metabolic Diseases (DGVS) on acceptance, application and optimization].","authors":"Joschka Bachmann, Pia Lorenz, Lars Klug, Ulrike Denzer, Heiner Wedemeyer, Petra Lynen Jansen","doi":"10.1055/a-2571-6123","DOIUrl":"10.1055/a-2571-6123","url":null,"abstract":"<p><p>Evidence-based guidelines are an important basis for medical action. The methodological effort to develop guidelines is high. Nevertheless, a high methodological effort in the development of guidelines does not automatically guarantee the success of a guideline, but it must be ensured that guidelines are also accepted and thus applied. Currently (as of October 2024), 28 guidelines are available, which were created under the leadership of the German Society for Gastroenterology, Digestive and Metabolic Diseases (DGVS). How these guidelines are perceived and used in everyday clinical practice and what obstacles exist in their implementation has been little researched so far.This study examines the acceptance and use of the DGVS guidelines with the aim of optimizing the guideline process and implementation.A questionnaire with 32 questions was designed, which included closed questions, Likert scales and free-text answers. The questionnaire was sent by e-mail to 7015 DGVS members. Answering the questionnaire was anonymous and voluntary. In subgroup analyses, physicians in outpatient care, hospitals and university hospitals, as well as physicians with or without experience in guideline development were compared.604 responses were evaluated (response rate 8.6%). The DGVS guidelines are ubiquitously well known and are considered extremely useful by 66% of respondents. They are the main source of information in everyday clinical practice, but their structure is considered to need improvement. Users trust the quality of guidelines regardless of the guideline classification. There are subgroup differences regarding the extent of use or the various reasons for the use of guidelines. In outpatient care, guidelines are more often used to protect oneself against causing a medical error compared to university hospitals, and the avoidance of overtreatment generally seems to be more important at non-university hospitals.Overall, the DGVS guidelines are rated positively. In different areas of medical practice there are different wishes and requirements for guidelines. Improving the topicality of the guidelines is the priority for most respondents. Further starting points for improvement are the structure of the guidelines and focusing on relevant content for everyday cliclinical practice, especially in outpatient care.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":" ","pages":"571-584"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic findings of Bouveret syndrome.","authors":"Johann von Felden, Julian Schulze Zur Wiesch, Tarik Ghadban, Thomas Rösch, Karsten Ohlhoff","doi":"10.1055/a-2515-3808","DOIUrl":"10.1055/a-2515-3808","url":null,"abstract":"<p><p>Bouveret syndrome is a rare complication of gallstone disease. We present a 76-year old male patient in whom the diagnosis was complicated by the reporting of coffee-ground emesis suggesting upper gastrointestinal bleeding. Considering the diagnosis of Bouveret syndrome is commonly made through cross-sectional imaging, these patients rarely undergo diagnostic endoscopy. However, this case presented with typical findings during emergency esophagogastroduodenoscopy (EGD) underscoring its educational value for gastroenterologists and endoscopists.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":" ","pages":"593-595"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Safety and Care After Outpatient Endoscopic Retrograde Cholangiopancreatography (ERCP): A Single-Center Experience in Germany.","authors":"Kien Vu Trung, Juergen Feisthammel, Albrecht Hoffmeister, Thomas Karlas","doi":"10.1055/a-2543-3380","DOIUrl":"10.1055/a-2543-3380","url":null,"abstract":"<p><p>The current goal of adapting care structures in the German healthcare system is to increase the provision of interventional treatments in outpatient settings. Endoscopic Retrograde Cholangiopancreatography (ERCP) procedures were traditionally performed in an inpatient setting until 2022. However, with the introduction of a new Ambulatory Surgery Contract (according to Section 115b, Paragraph 1 of the Social Code, Book V) on January 1, 2023, these procedures are now intended to be carried out more strictly on an outpatient basis, meaning that hospitalization will no longer be reimbursed in most cases.Between June 1, 2023, and December 31, 2023 all ERCP procedures performed in an outpatient setting were included in this study. This cohort had standard ERCP indications and a low comorbidity burden according to the §115b specifications. Using propensity score matching (nearest-neighbor), these cases were matched with patients who underwent ERCP procedures in an inpatient setting between June 1, 2022, and December 31, 2022.Propensity-score matching identified a cohort of 166 patients (83 outpatients and 83 inpatients) with similar baseline characteristics. The most common indications for ERCP were choledocholithiasis and biliary strictures. Reported complications comprised pancreatitis, bleeding and cholangitis and were rare in both groups, occurring in 7% of inpatient procedures and in 6% of outpatient procedures. The latter cases required inpatient admission after self-presenting to the emergency department. No serious adverse events were reported.Outpatient ERCP is a safe procedure for selected patients with a low risk profile. Complications occurred rarely and could be adequately managed.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":" ","pages":"585-592"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Therapeutics and (hypothetical) vaccinations against human cryptosporidia].","authors":"Yannick Borkens","doi":"10.1055/a-2551-1670","DOIUrl":"10.1055/a-2551-1670","url":null,"abstract":"<p><p><i>Cryptosporidium</i> (or cryptosporidiosis caused by them) is one of the most relevant infections of the intestinal tract. The unicellular parasites infect the intestinal cells and cause cramps, weight loss and diarrhea. Cryptosporidia play a special role in AIDS patients. Here they are counted among the diseases that define the acquired immunodeficiency syndrome. Because of this relevance, the search for vaccines is a relevant goal of gastroenterological research. But how realistic are such vaccines? This article describes the disease cryptosporidiosis and reviews current therapeutics and hypothetical vaccine candidates.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":" ","pages":"596-603"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Correction: AWMF-Registernummer: 032-010OL - Leitlinie (Kurzversion)].","authors":"Thomas Seufferlein, Julia Mayerle, Stefan Boeck, Thomas Brunner, Thomas J Ettrich, Lars Grenacher, Thomas Mathias Gress, Thilo Hackert, Volker Heinemann, Angelika Kestler, Marianne Sinn, Andrea Tannapfel, Waldemar Uhl, Ulrich Wedding","doi":"10.1055/a-2618-6445","DOIUrl":"https://doi.org/10.1055/a-2618-6445","url":null,"abstract":"","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}