Sabrina Groß, Michael Bitzer, 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 J 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 biliärer Karzinome – Kurzversion.","authors":"Sabrina Groß, Michael Bitzer, 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 J 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-2446-2454","DOIUrl":"https://doi.org/10.1055/a-2446-2454","url":null,"abstract":"","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":"63 2","pages":"169-203"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371230","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, 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 biliärer Karzinome – Langversion.","authors":"Sabrina Groß, Michael Bitzer, 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-2460-6347","DOIUrl":"https://doi.org/10.1055/a-2460-6347","url":null,"abstract":"","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":"63 2","pages":"e82-e158"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371204","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}
Falk Rauchfuss, Laura Schwenk, Philipp A Reuken, Alexander Zipprich, Sebastian Schwarz, Michael Bauer, Andreas Stallmach, Utz Settmacher
{"title":"Liver transplantation in alcohol-induced acute-on-chronic liver failure without six months of abstinence.","authors":"Falk Rauchfuss, Laura Schwenk, Philipp A Reuken, Alexander Zipprich, Sebastian Schwarz, Michael Bauer, Andreas Stallmach, Utz Settmacher","doi":"10.1055/a-2497-1996","DOIUrl":"10.1055/a-2497-1996","url":null,"abstract":"<p><p>Globally, many liver transplantation programs require adherence to a 6-month abstinence period in cases of alcohol-associated liver disease. Especially in cases of decompensation, such as acute-on-chronic liver failure (ACLF), the severity of the disease often makes it impossible to reach this interval, leading to increasing critical scrutiny of a fixed abstinence period. The prognostic relevance of the 6-month abstinence is also not firmly established.In the present study, we analyze all patients who were presented for liver transplantation at a German transplantation center due to acute-on-chronic liver failure caused by alcohol-associated liver disease.Retrospective analyses of patients with alcohol-associated liver disease who did not complete the 6-month abstinence period.Out of the 83 patients initially considered, 78 were included in the final analysis. The patients who underwent liver transplantation (n=16) had a significantly better 5-year survival rate (81.3% vs. 24.2%; p < 0.001). Especially in patients with ACLF and multiple organ dysfunctions (ACLF Grade 3), liver transplantation resulted in a significantly improved survival rate. Patients with an ACLF Grade 3 who were not transplanted died within the first six months after decompensation (92.5% mortality). All surviving transplant recipients continued abstaining from alcohol until the most recent evaluation point (average follow-up time 963 days).Patients experiencing acute-on-chronic liver failure from alcohol-related liver disease clearly benefit from liver transplantation, irrespective of whether they meet the 6-month abstinence criterion. This stipulated waiting period is increasingly debated in current discussions. Our findings emphasize that patients with ACLF, when not transplanted, face significant mortality risks. Such insights should be factored into tailored treatment decisions.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":"63 2","pages":"133-138"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371228","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":"[40-year-old-patient with perianal pain, signs of inflammation and stool retention].","authors":"Martin Killermann, Edith Weigert, Marc Dauer","doi":"10.1055/a-2446-1043","DOIUrl":"10.1055/a-2446-1043","url":null,"abstract":"","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":"63 1","pages":"29-30"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142965641","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 Klausner, Roman Feller, Wolfgang Vogt, Henning Wege
{"title":"[Percutaneous endoscopic gastrostomy in a 42-year-old patient with suspected variant of Creutzfeld Jakob disease using a disposable bronchoscope].","authors":"Michael Klausner, Roman Feller, Wolfgang Vogt, Henning Wege","doi":"10.1055/a-2406-9419","DOIUrl":"10.1055/a-2406-9419","url":null,"abstract":"<p><p>Prion diseases pose a challenge for flexible reusable endoscopes. Especially for the new variant of Creutzfeld Jakob disease (vCJD) there is currently no suitable processing procedure. In these patients only disposable endoscopes are hygienically safe. The case report shows a PEG placement in a 42-year-old patient with suspected vCJD using a disposable bronchoscope.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":" ","pages":"53-55"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717242","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":"Tissue Determinants of Antiviral Immunity in the Liver.","authors":"Dirk Wohlleber, Percy A Knolle","doi":"10.1055/a-2365-3900","DOIUrl":"10.1055/a-2365-3900","url":null,"abstract":"<p><p>The liver is an organ bearing important metabolic and immune functions. Hepatocytes are the main metabolically active cells of the liver and are the target of infection by hepatotropic viruses. Virus-specific CD8 T cells are essential for the control of hepatocyte infection with hepatotropic viruses but may be subject to local regulation of their effector function. Here, we review our current knowledge of the tissue determinants of antiviral immunity in the liver. Liver Sinusoidal Endothelial Cells (LSECs) not only allow through their fenestrations the access of circulating virus-specific CD8 T cells to engage in direct contact with infected hepatocytes without the need for extravasation but also cross-present viral antigens released from infected hepatocytes to these CD8 T cells. Two important features of LSECs and hepatocytes contribute to antiviral immune surveillance and liver failure. First, CD8 T cell immunity targeting LSECs leads to widespread endothelial cell death and results in sinusoidal microcirculation failure, causing fulminant viral hepatitis, whereas immune-mediated loss of hepatocytes is rapidly compensated by the regenerative capacity of the liver. Second, virus-infected hepatocytes support clearance of infection by responding to TNF, which is released from virus-specific CD8 T cells, with the selective induction of apoptosis. This increased sensitivity for TNF-induced death is caused by reduced mitochondrial resilience in virus-infected hepatocytes and may assist antiviral immunity in preferential targeting of virus-infected hepatocytes. Thus, hepatocytes and LSECs actively contribute to the outcome of antiviral CD8 T cell immunity in the liver. The knowledge of the mechanisms determining CD8 T cell control of hepatotropic viral infection will help to improve strategies to increase antiviral immune surveillance.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":"63 1","pages":"65-72"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142966646","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}
Dietrich Hüppe, Yvonne Serfert, Markus Cornberg, Heiner Wedemeyer
{"title":"[Significant increase in newly diagnosed hepatitis B and C cases in Germany due to screening].","authors":"Dietrich Hüppe, Yvonne Serfert, Markus Cornberg, Heiner Wedemeyer","doi":"10.1055/a-2435-5069","DOIUrl":"10.1055/a-2435-5069","url":null,"abstract":"<p><p>In 2016, the World Health Organization (WHO) decided on an initiative to identify 90% of the world's existing hepatitis B and C virus infections by 2030, treat 80% and reduce the mortality by 65%. In 2016, the federal government endorsed these goals. From Oct 1, 2021, the G-BA included a one-time screening for hepatitis B and C in the health examination (GU) for people aged 35 and over who have statutory health insurance. The previous participation rates in the GU were evaluated and the effectiveness of the program is documented using the reporting data on hepatitis B and C of Robert Koch Institute (RKI).Notifications from Central Institute of Statutory Health Insurance (ZI) and Scientific Institute of the local health insurance companies (WIdO) were compiled with regard to the GU, the reporting data from the RKI were collected and analyzed using SURVSTAT@RKI 2.0 as well as billing data from the Association of Statutory Health Insurance Physicians (KBV).Between 2007 and 2021, around 83% of all insured persons took part in a GU at least once. From the fourth quarter of 2021, the number of newly diagnosed cases of hepatitis B and C increased. In 2022, the increase for hepatitis B was 91.9% and for hepatitis C 68%. This trend continued in 2023, with new diagnoses of hepatitis B increasing by 160% (to 22,795 cases) and hepatitis C increasing by 121% (to 10,508 cases) compared to 2021. The analysis of the KBV billing data showed that the increase in new diagnoses shows a strong correlation between the number of new diagnoses within the GU and the total number of diagnoses.The decision of the Federal Joint Committee (G-BA) to include hepatitis B and C screening in the GU seems to be a success in detecting previously undetected cases of the disease. Based on the billing data from the KBV, a high level of agreement could be demonstrated between the number of new diagnoses within the GU and the increase in the total number of diagnoses. The goals of the WHO may be achievable.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":" ","pages":"31-38"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717244","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":"Liver damage and immune responses.","authors":"Carl-Philipp Hackstein","doi":"10.1055/a-2365-3796","DOIUrl":"10.1055/a-2365-3796","url":null,"abstract":"<p><p>Chronic liver disease (CLD) has massive systemic repercussions including major impacts on the body's immune system. Abnormalities in phenotype, function and numbers of various immune cell subsets have been established by a large number of clinical and pre-clinical studies. The loss of essential immune functions renders CLD-patients exceptionally susceptible to bacterial and viral infections and also impairs the efficacy of vaccination. Consequently, infections represent a major clinical issue causing significant morbidity and mortality in these patients. Mechanistically, the immune dysfunction associated with CLD results from the increased translocation of bacteria and bacterial cues from the intestine. These trigger a signaling axis around the cytokines IFN I and IL-10 in hepatic myeloid cells, which aside from impairing the function of the myeloid cells themselves, also has notable negative impacts on the functionality of other immune cells. T cells in CLD-patients and -models are especially affected by this signaling axis and display a variety of quantitative and qualitative defects. Due to the high clinical relevance, understanding the mechanisms underlaying CED-associated immune dysfunction is of critical importance to discover and develop new therapeutic targets.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":"63 1","pages":"56-64"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142966697","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}
Igors Iesalnieks, Natascha von Rebay, Robert Patejdl, Maximilian Tiller, Tobias Müller, Florian Schertl, Holger Seidl, Sophia Patejdl, Martin Motschmann, Sebastian Roggenbrod, Ayman Agha, Wolfgang Schepp, Felix Gundling
{"title":"[Gastric electrostimulation in refractory gastroparesis: results of a explorative observational study].","authors":"Igors Iesalnieks, Natascha von Rebay, Robert Patejdl, Maximilian Tiller, Tobias Müller, Florian Schertl, Holger Seidl, Sophia Patejdl, Martin Motschmann, Sebastian Roggenbrod, Ayman Agha, Wolfgang Schepp, Felix Gundling","doi":"10.1055/a-2451-0116","DOIUrl":"10.1055/a-2451-0116","url":null,"abstract":"<p><p>High-frequency electrical stimulation therapy (gastric electrical stimulation, GES) is a treatment option for gastroparesis of various genesis. The best indication and prognostic parameters have not yet been conclusively determined.Retrospective analysis of all gastroparesis patients implanted with a GES device between 2011 and 2020. Clinical response was measured before and after implantation using a validated Gastroparesis Cardinal Symptom Index (GCSI) (maximum score: 5, minimum score: 0). Other study endpoints included: subjective symptom course (no improvement, partial improvement, or severe improvement) and change in gastroparesis medication.A GES device was implanted in 42 patients (16 M: 26 F, mean age 45 years). The etiology of gastroparesis was diabetic (n=23), idiopathic (n=10) or postoperative (n=9). Eleven patients (26%) had undergone one or more invasive treatments before. GCSI score of the total group was 3.23 preoperatively. The median follow-up time was 12 months. In the overall group, significant improvement in GCSI score was found 3, 6, 9, and 12 months postoperatively-regardless of indication. In multivariate analysis, disease duration of >30 months was associated with a significantly decreased GCSI score at 12 months (p<0.001). Approximately 40% of patients were able to discontinue or significantly reduce gastroparesis medication. At the end of follow-up, 81% of patients reported partial or major improvement in symptoms. During the follow-up period, three patients (7%) died.Gastric electrical neurostimulation is an effective and safe option for refractory gastroparesis-regardless of the underlying disease.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":"63 1","pages":"39-48"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142966682","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}
Jonas Schumacher, Henning Trawinski, Hans-Michael Tautenhahn, Hendrik Bläker, Johannes Wiegand
{"title":"Alveolar Echinococcosis - Diagnostic challenges of a parasitic disease on the rise in Europe - a case report.","authors":"Jonas Schumacher, Henning Trawinski, Hans-Michael Tautenhahn, Hendrik Bläker, Johannes Wiegand","doi":"10.1055/a-2414-1320","DOIUrl":"10.1055/a-2414-1320","url":null,"abstract":"<p><p>A 45-year-old male presented with jaundice, abdominal discomfort, and weight loss. Abdominal ultrasound revealed intrahepatic cholestasis and cholelithiasis indicative of Caroli-syndrome. Subsequent magnetic resonance imaging demonstrated a corresponding 5 × 4 cm polycyclic, calcified mass and a distant 12 mm subhilar stenosis of the common bile duct resembling cholangiocarcinoma. Calcifications seemed unusual and brought up differential diagnosis of echinococcosis. Serology revealed an echinococcus antibody-titer of 33 U (cut-off > 11.5 U). However, the clinical presentation with jaundice, weight loss, and a distant subhilar stenosis of the common bile duct without association to the intrahepatic process led to underestimation of the positive antibody-titer. Thus, the patient underwent right hemihepatectomy for potential cholangiocarcinoma. Dense infiltrative small cysts interspersed the resected right lobe of the liver. Histopathology revealed a granulomatous inflammation surrounding typical cuticulas, confirming hepatobiliary alveolar echinococcosis. Alveolar echinococcosis is considered as one of the neglected diseases by the World Health Organization, although incidence is rising worldwide and specifically in Germany. Our case illustrates hurdles in diagnosing alveolar echinococcosis and underlines the importance to be aware of classical and rare clinical manifestations.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":" ","pages":"49-52"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717246","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}
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