Michael Rietz, Tobias Weber, Tina Schaller, Jan Hendrik Luitjens, Luise Uhrmacher, Helmut Messmann, Andreas Probst
{"title":"Severe gastroparesis complicated by gastric perforation caused by lightchain amyloidosis.","authors":"Michael Rietz, Tobias Weber, Tina Schaller, Jan Hendrik Luitjens, Luise Uhrmacher, Helmut Messmann, Andreas Probst","doi":"10.1055/a-2442-7944","DOIUrl":"10.1055/a-2442-7944","url":null,"abstract":"<p><p>AL-Amyloidosis is a rare systemic disease that can occur in patients with monoclonal gammopathy or multiple myeloma. As multiple organs may be affected by deposition of amyloid fibrils, the clinical presentation varies considerably, and the diagnostic process may be challenging.We report on a 59-year-old female who suffered from gastroesophageal reflux symptoms, nausea, epigastric pain, and meteorism over several years. Repeated upper GI endoscopies including biopsies and CT scans were unremarkable except for unspecific enlargement of mesenterial lymph nodes.A few weeks after a surgical hiatal hernia repair with fundoplication, the patient developed massive distension of the stomach and the proximal duodenum resulting in gastric perforation. Histopathological staining of gastric biopsies and mesenterial lymph nodes using hematoxylin and eosin was unremarkable. Because of endoscopic findings (submucosal hematomas, and ulcerations) and the unexplained severe motility disorder, histopathological staining was performed using Congo red. Extensive amyloid deposits were seen. Further workup confirmed AL amyloidosis caused by monoclonal gammopathy. Specific oncological treatment was started.The rare differential diagnosis of amyloidosis should be taken into account in patients with unexplained motility disorders, unspecific gastrointestinal symptoms, and abdominal lymphadenopathy. In the presented case, delayed diagnosis of AL amyloidosis in the gastrointestinal tract led to severe gastroparesis resulting in gastric perforation. Specific histopathologic staining can confirm the diagnosis.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":" ","pages":"387-392"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717253","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}
Kristijan Skok, Judith Stift, Peter Schirmacher, Karl Kashofer, Rudolf Stauber, Branislava Ranković, Karoline Lackner
{"title":"Molecular Landscape and Treatment Paradigms of Hepatocellular and Cholangiocarcinoma: A Multinational Review.","authors":"Kristijan Skok, Judith Stift, Peter Schirmacher, Karl Kashofer, Rudolf Stauber, Branislava Ranković, Karoline Lackner","doi":"10.1055/a-2548-0108","DOIUrl":"10.1055/a-2548-0108","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA) represent the most prevalent primary liver cancers and pose significant challenges in oncology. While their etiology and incidence vary globally, the molecular landscape of these tumors is increasingly understood, offering new opportunities for precision medicine. In this joint multinational review, we present a comprehensive analysis of the key molecular pathways involved in the pathogenesis of HCC and CCA, highlighting actionable targets for emerging therapies. Recent advances in molecular diagnostics have significantly influenced treatment paradigms for both cancers. In HCC, while genetic alterations have not yet led to established diagnostic or therapeutic applications, targeting vascular endothelial growth factor (VEGF), immune checkpoints, and tyrosine kinase pathways has demonstrated considerable therapeutic potential. In CCA, genetic profiling has uncovered actionable alterations, such as FGFR2 fusions and IDH1 mutations, driving the development of targeted therapies. The growing complexity of precision oncology underscores the need for standardized molecular testing and streamlined diagnostic workflows to ensure timely and effective treatment. This review also emphasizes the importance of collaborative efforts between clinicians, pathologists, and oncologists to optimize outcomes. By synthesizing the latest molecular insights and treatment trends, this review provides a valuable resource to guide the personalized management of HCC and CCA.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754793","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}
Dominik Schweikart, Matthias Baur, Dominique Walter, Benjamin Walter
{"title":"[Rethinking Endoscopy: Strategies from Aviation and their Transfer to Medicine - An Overview].","authors":"Dominik Schweikart, Matthias Baur, Dominique Walter, Benjamin Walter","doi":"10.1055/a-2545-9524","DOIUrl":"10.1055/a-2545-9524","url":null,"abstract":"<p><p>The demands on modern endoscopy have grown rapidly in various areas in recent decades. These include challenges for the endoscopy team due to more demanding interventional procedures, but also the rapidly changing conditions that today's working reality entails. In order to continue to meet the necessary safety and quality standards, it can help to look at similarly complex areas such as civil aviation to find inspiration for effective concepts in endoscopy.Crew Resource Management (CRM) and Threat and Error Management (TEM) are important concepts from civil aviation that currently make aviation the safest mode of transportation in the world. Elements such as communication, teamwork, situational awareness, decision-making and an open error culture can also be used in medicine. Some of these have already been successfully transferred to acute medical areas by using CRM-based training and general or specific checklists. In order to also benefit as much as possible from the findings in endoscopy, workshops tailored to the individual requirements of the respective endoscopy unit are available, in which measures can be developed in collaboration with professional CRM trainers. Examples of this would be a standardized communication guideline for endoscopic procedures, a pre-interventional safety checklist or a TEM-based dialogical team time-out. After implementation, regular evaluation and further development of the measures are essential for long-term success.Elements transferred from civil aviation have the potential to promote communication, situation-aware teamwork, structured decision-making and an open error culture in endoscopic teams and thus contribute to safe and high-quality interventions.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744066","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}
Jan Däbritz, Martin Classen, Kathrin Krohn, Andreas Krahl, Stephan Buderus, Elke Lainka, Jan de Laffolie, Carsten Posovszky
{"title":"[Correction: Position paper of the Society for Paediatric Gastroenterology and Nutrition (GPGE) on the off-label use of biologics and signal inhibitors in children and adolescents with IBD that have already been approved for adults].","authors":"Jan Däbritz, Martin Classen, Kathrin Krohn, Andreas Krahl, Stephan Buderus, Elke Lainka, Jan de Laffolie, Carsten Posovszky","doi":"10.1055/a-2543-1671","DOIUrl":"10.1055/a-2543-1671","url":null,"abstract":"","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":" ","pages":"e294"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Johannes Reiner, Anne-Sophie Becker, Astrid Huth, Georg Lamprecht, Maria Witte
{"title":"Mirikizumab for the treatment of chronic antibiotic-refractory pouchitis.","authors":"Johannes Reiner, Anne-Sophie Becker, Astrid Huth, Georg Lamprecht, Maria Witte","doi":"10.1055/a-2404-4518","DOIUrl":"10.1055/a-2404-4518","url":null,"abstract":"<p><p>The current standard of care for the definitive surgical treatment of complicative ulcerative colitis is a continence-preserving proctocolectomy with the creation of an ileal pouch anal anastomosis. In addition to structural and functional disorders, pouchitis of the J-pouch is a common phenomenon, typically well responsive to antimicrobial therapy. However, sometimes chronic antibiotic-refractory pouchitis occurs, most often due to not completely understood multifactorial pathomechanisms. While high-quality evidence is available only for anti-integrin therapy, the role of advanced therapy, i.e., cytokine-antibodies or small molecules in the treatment of chronic antibiotic-refractory pouchitis (CARP), is emerging.This case demonstrates a successful induction treatment of CARP with the novel p19-selective IL-23-targeted antibody mirikizumab.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":" ","pages":"269-272"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355203","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}
Jan Däbritz, Martin Classen, Kathrin Krohn, Andreas Krahl, Stephan Buderus, Elke Lainka, Jan de Laffolie, Carsten Posovszky
{"title":"[Position paper of the Society for Paediatric Gastroenterology and Nutrition (GPGE) on the off-label use of biologics and signal inhibitors in children and adolescents with IBD that have already been approved for adults].","authors":"Jan Däbritz, Martin Classen, Kathrin Krohn, Andreas Krahl, Stephan Buderus, Elke Lainka, Jan de Laffolie, Carsten Posovszky","doi":"10.1055/a-2474-3104","DOIUrl":"10.1055/a-2474-3104","url":null,"abstract":"<p><p>Therapy for children and adolescents with chronic inflammatory bowel disease (IBD) is basically no different from that for adult patients. However, of the steadily increasing number of biologics and signalling inhibitors for adults, only two TNFα antibodies are currently approved in Germany for the treatment of IBD from the age of 6. This means that a large proportion of the drugs authorised for adults with IBD are not available for children and adolescents with moderate to severe disease. The small number of approved drugs also makes it difficult to achieve the prognostically important goal of achieving a sustained remission of IBD soon after diagnosis, which is characterised by the patient being free of symptoms and also the objectifiable goal of mucosa healing. This position paper is intended to present the current study situation on the drug treatment of children and adolescents with IBD outside the age limit and to serve as a basis for information and decision-making for the Medical Service in the assessment of individual case applications as well as for the treating physicians, the cost bearers, health policy and social court decision-makers.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":" ","pages":"255-268"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11893210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dieter Nürnberg, Christian Jenssen, Claudia Lucius, Rolf Klingenberg-Noftz, Matthias Wüstner, Hans Worlicek, Daniel Merkel, Nicole Eder, Hendra Lo, Maria Nürnberg, Christoph F Dietrich
{"title":"[Clinical Ultrasound (ClinUS) - Concepts and Controversies].","authors":"Dieter Nürnberg, Christian Jenssen, Claudia Lucius, Rolf Klingenberg-Noftz, Matthias Wüstner, Hans Worlicek, Daniel Merkel, Nicole Eder, Hendra Lo, Maria Nürnberg, Christoph F Dietrich","doi":"10.1055/a-2495-2677","DOIUrl":"10.1055/a-2495-2677","url":null,"abstract":"<p><p>Clinical ultrasound (ClinUS) is the integration of ultrasound diagnostics into the clinical examination. By comparing clinical ultrasound with other models of ultrasound diagnostics, this overview presents a concept that integrates point-of-care ultrasound, comprehensive specialty-specific ultrasound examinations and specialized multiparametric ultrasound. The applications, advantages and challenges of clinical ultrasound and its special features in comparison to other cross-sectional imaging modalities are discussed using the example of gastroenterology and general medicine in particular.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":" ","pages":"279-292"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426386","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}
Sebastian Zundler, Kerstin Wolff, Moritz Leppkes, Anne Gaza, Sophie Haberkamp, Deike Strobel, Jürgen Siebler, Markus F Neurath, Maximilian Waldner
{"title":"Palliative treatment of malignant intestinal obstruction with EUS-guided ileosigmoidostomy - a case report.","authors":"Sebastian Zundler, Kerstin Wolff, Moritz Leppkes, Anne Gaza, Sophie Haberkamp, Deike Strobel, Jürgen Siebler, Markus F Neurath, Maximilian Waldner","doi":"10.1055/a-2452-4337","DOIUrl":"10.1055/a-2452-4337","url":null,"abstract":"<p><p>We present the case of a 70-year-old patient of Caucasian origin under palliative chemotherapy for metastasized colorectal cancer, who presented with signs of complete small bowel obstruction six months after placement of a diverting ileostomy. Following previous tumor perforation, he was not considered a candidate for further surgical intervention.Thus, endoscopic ultrasound-guided enterocolostomy (i.e., ileosigmoidostomy) with a lumen-apposing metal stent was successfully performed in a coloenteric approach to restore the passage.Oral nutrition could be resumed the next day, and the patient could be discharged in substantially improved condition after three days.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":" ","pages":"273-278"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717251","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}
Michael Bitzer, Sabrina Groß, Jörg Albert, Susanne Blödt, Judit Boda-Heggemann, Katrin Borucki, Thomas Brunner, Reiner Caspari, Frank Dombrowski, Matthias Evert, Markus Follmann, Paul Freudenberger, Cihan Gani, Jamila Gebert, Andreas Geier, Eleni Gkika, Martin Götz, Thomas Helmberger, Ralf-Thorsten Hoffmann, Peter Huppert, David Krug, Christian La Fougère, Hauke Lang, Thomas Langer, Philipp Lenz, Tom Lüdde, Andreas Mahnken, Silvio Nadalin, Hoa Huu Phuc Nguyen, Monika Nothacker, Johann Ockenga, Karl Oldhafer, Julia Ott, Philipp Paprottka, Philippe Pereira, Thorsten Persigehl, Ruben Plentz, Jürgen Pohl, Heinrich Recken, Peter Reimer, Jutta Riemer, Kristina Ringe, Elke Roeb, Jörn Rüssel, Barbara Schellhaas, Peter Schirmacher, Hans Jürgen Schlitt, Irene Schmid, Kerstin Schütte, Andreas Schuler, Daniel Seehofer, Marianne Sinn, Andreas Stengel, Nadine Steubesand, Christoph Stoll, Andrea Tannapfel, Anne Taubert, Jörg Trojan, Ingo van Thiel, Martin Utzig, Arndt Vogel, Thomas Vogl, Frank Wacker, Oliver Waidmann, Heiner Wedemeyer, Henning Wege, Gregor Wenzel, Dane Wildner, Marcus-Alexander Wörns, Peter Galle, Nisar Malek
{"title":"S3-Leitlinie Diagnostik und Therapie des Hepatozellulären Karzinoms – Langversion.","authors":"Michael Bitzer, Sabrina Groß, Jörg Albert, Susanne Blödt, Judit Boda-Heggemann, Katrin Borucki, Thomas Brunner, Reiner Caspari, Frank Dombrowski, Matthias Evert, Markus Follmann, Paul Freudenberger, Cihan Gani, Jamila Gebert, Andreas Geier, Eleni Gkika, Martin Götz, Thomas Helmberger, Ralf-Thorsten Hoffmann, Peter Huppert, David Krug, Christian La Fougère, Hauke Lang, Thomas Langer, Philipp Lenz, Tom Lüdde, Andreas Mahnken, Silvio Nadalin, Hoa Huu Phuc Nguyen, Monika Nothacker, Johann Ockenga, Karl Oldhafer, Julia Ott, Philipp Paprottka, Philippe Pereira, Thorsten Persigehl, Ruben Plentz, Jürgen Pohl, Heinrich Recken, Peter Reimer, Jutta Riemer, Kristina Ringe, Elke Roeb, Jörn Rüssel, Barbara Schellhaas, Peter Schirmacher, Hans Jürgen Schlitt, Irene Schmid, Kerstin Schütte, Andreas Schuler, Daniel Seehofer, Marianne Sinn, Andreas Stengel, Nadine Steubesand, Christoph Stoll, Andrea Tannapfel, Anne Taubert, Jörg Trojan, Ingo van Thiel, Martin Utzig, Arndt Vogel, Thomas Vogl, Frank Wacker, Oliver Waidmann, Heiner Wedemeyer, Henning Wege, Gregor Wenzel, Dane Wildner, Marcus-Alexander Wörns, Peter Galle, Nisar Malek","doi":"10.1055/a-2460-6298","DOIUrl":"https://doi.org/10.1055/a-2460-6298","url":null,"abstract":"","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":"63 3","pages":"e159-e260"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597765","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}
Sabrina Groß, Michael Bitzer, Susanne Blödt, Nadine Fischer, Markus Follmann, Paul Freudenberger, Jamila Gebert, Thomas Langer, Petra Lynen Jansen, Monika Nothacker, Julia Ott, Nadine Steubesand, Peter R Galle, Nisar P Malek
{"title":"Leitlinienreport der S3-Leitlinie „Diagnostik und Therapie des Hepatozellulären Karzinoms und biliärer Karzinome“.","authors":"Sabrina Groß, Michael Bitzer, Susanne Blödt, Nadine Fischer, Markus Follmann, Paul Freudenberger, Jamila Gebert, Thomas Langer, Petra Lynen Jansen, Monika Nothacker, Julia Ott, Nadine Steubesand, Peter R Galle, Nisar P Malek","doi":"10.1055/a-2446-2509","DOIUrl":"https://doi.org/10.1055/a-2446-2509","url":null,"abstract":"","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":"63 3","pages":"e261-e293"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597751","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}