Zeitschrift fur Gastroenterologie最新文献

{"title":"Angioinvasive gastrointestinal mucormycosis with duodenal necrosis and perforation in a patient with visceral myopathy.","authors":"Nicole Hunter, Alexander Kusnik, Layla Hatem, Ari Chodos, Anthony Baratta, Prasad Penmetsa, Yana Levin","doi":"10.1055/a-2053-9149","DOIUrl":"10.1055/a-2053-9149","url":null,"abstract":"<p><p>A 55-year-old woman with a past medical history of visceral myopathy with multiple resultant abdominal surgeries, colectomy caused by severe pseudo-obstruction, and end-stage renal disease on hemodialysis presented with complaints of nausea, abdominal distention, vomiting, and diarrhea for five days. Small-bowel obstruction was identified on CT. She subsequently developed acute gastrointestinal bleeding, anemia, and hemodynamic instability. Extensive gastric ulceration with frank hemorrhage prompted urgent subtotal gastrectomy with multiple intraoperative findings, including a necrotic distal duodenum. Surgical pathology showed invasive fungal infection of the duodenum with perforation, morphologically compatible with invasive mucormycosis. The patient was started on intravenous liposomal amphotericin B, but despite best efforts, the patient ultimately succumbed to this invasive fungal infection in addition to sepsis and multi-organ failure.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9295464","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-Leitlinie „Diagnostik und Therapie biliärer Karzinome“ – Langversion 4.0.","authors":"Sabrina Groß, Michael Bitzer, Jörg Albert, Susanne Blödt, Judit Boda-Heggemann, Thomas Brunner, Reiner Caspari, Enrico De Toni, Frank Dombrowski, Matthias Evert, Markus Follmann, Paul Freudenberger, Cihan Gani, 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, Philipp Paprottka, Philippe Pereira, Thorsten Persigehl, Ruben Plentz, Jürgen Pohl, Heinrich Recken, Peter Reimer, Jutta Riemer, Ulrike Ritterbusch, Elke Roeb, Jörn Rüssel, Barbara Schellhaas, Peter Schirmacher, Hans J Schlitt, Irene Schmid, Andreas Schuler, Daniel Seehofer, Marianne Sinn, Andreas Stengel, Nadine Steubesand, Christoph Stoll, Andrea Tannapfel, Anne Taubert, Reina Tholen, Jörg Trojan, Ingo van Thiel, Arndt Vogel, Thomas Vogl, Frank Wacker, Oliver Waidmann, Heiner Wedemeyer, Henning Wege, Dane Wildner, Marcus-Alexander Wörns, Peter Galle, Nisar Malek","doi":"10.1055/a-2189-8567","DOIUrl":"10.1055/a-2189-8567","url":null,"abstract":"","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139747529","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 the forest to the ICU and back: an investigative work-up of Amanita phalloides poisoning].","authors":"Mohamad Murad, Teresa M Anslinger, Daniel Frank, Philipp Hohlstein, Liette van den Burg, Jonathan Frederik Brozat, Maike R Pollmanns, Malin Fromme, Marie Grünert, Richard Lubberich, Theresa H Wirtz, Karim Hamesch, Christian Trautwein, Samira Abu Jhaisha, Alexander Koch","doi":"10.1055/a-2028-7630","DOIUrl":"10.1055/a-2028-7630","url":null,"abstract":"<p><p>With over 90% of deaths following mushroom ingestion, poisoning with Amatoxin is one of the most dangerous food intoxications. Despite numerous case reports, treatment recommendations are based on a moderate level of evidence due to a lack of randomized controlled trials.We present the case of a 32-year-old patient who presented with acute liver failure after Amanita phalloides (green death cap mushroom) ingestion and whose therapeutic success was significantly influenced by the administration of activated charcoal, silibinin, and N-acetylcysteine as well as the determined research of an external mycologist.In various retrospective studies, a relevant reduction of mortality could be shown by the mentioned medicinal measures. Despite the high estimated amount of ingestion, we could confirm the effectiveness of this combination therapy in this case.Here, in addition to the drug therapy, attention should also be paid to the extraordinary cooperation of a mycologist, who was able to confirm the suspected diagnosis by his investigative approach and thus contributed to the success of the therapy. Immediate contact with the competent poison centre and the involvement of an expert is therefore recommended in unclear situations.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9246964","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":"Walking exercise through smartphone application plus branched-chain amino acid supplementation benefits skeletal muscle mass and strength in liver cirrhosis: A prospective control trial.","authors":"Qian Xiang, Jing Xiong, Zhi Jing Zhao, Ting Zhou, Jun Wu, Xia Chen","doi":"10.1055/a-2075-0130","DOIUrl":"10.1055/a-2075-0130","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Whether a combination of exercise and branched-chain amino acid (BCAA) supplementation was more beneficial than those given alone in sarcopenia related to liver cirrhosis (LC) is unknown. Widely used smartphone applications provide continuous and easily expandable management of chronic liver disease (CLD). This study is to investigate the effects of unsupervised walking exercise using WeChat combined with BCAA supplementation on skeletal muscle mass and strength in LC.</p><p><strong>Materials and methods: </strong>The 127 LC patients of Child-Pugh A/B were assigned to group A (BCAA supplements, n=42), group B (walking exercise, n=43) and group C (walking exercise plus BCAA supplements, n=42). Laboratory data, average daily steps, serum BCAA, skeletal muscle mass index (SMI) and grip strength were analyzed pre- and 3 months after interventions.</p><p><strong>Results: </strong>Of the 124 patients who completed interventions, albumin and daily steps were significantly increased in all groups (<i>p</i>=0.0001). Post-intervention BCAA were significantly elevated in group A (A vs B, <i>p</i>=0.001) and C (C vs B, <i>p</i>=0.012;). While post-intervention daily steps in group B (B vs A, <i>p</i>=0.0001) and C (C vs A, <i>p</i>=0.0001) were higher. Grip strength (C vs A, <i>p</i>=0.020; C vs B, <i>p</i>=0.036) and SMI (C vs A, <i>p</i>=0.035; C vs B, <i>p</i>=0.012) were increased in group C. Prevalence of sarcopenia was significantly decreased in group C (<i>p</i>=0.015).</p><p><strong>Conclusions: </strong>A combination of unsupervised walking exercise using smartphone applications and BCAA supplementation might be an effective and safe treatment for cirrhosis patients with Child-Pugh A/B to improve skeletal muscle mass and strength or to prevent progress of sarcopenia.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10872727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9510079","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}

{"title":"S3-Leitlinie „Diagnostik und Therapie biliärer Karzinome“ – Kurzversion.","authors":"Michael Bitzer, Sabrina Groß, Jörg Albert, Susanne Blödt, Judit Boda-Heggemann, Thomas Brunner, Reiner Caspari, Enrico De Toni, Frank Dombrowski, Matthias Evert, Markus Follmann, Paul Freudenberger, Cihan Gani, 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, Philipp Paprottka, Philippe Pereira, Thorsten Persigehl, Ruben Plentz, Jürgen Pohl, Heinrich Recken, Peter Reimer, Jutta Riemer, Ulrike Ritterbusch, Elke Roeb, Jörn Rüssel, Barbara Schellhaas, Peter Schirmacher, Hans Jürgen Schlitt, Irene Schmid, Andreas Schuler, Daniel Seehofer, Marianne Sinn, Andreas Stengel, Nadine Steubesand, Christoph Stoll, Andrea Tannapfel, Anne Taubert, Reina Tholen, Jörg Trojan, Ingo van Thiel, Arndt Vogel, Thomas Vogl, Frank Wacker, Oliver Waidmann, Heiner Wedemeyer, Henning Wege, Dane Wildner, Marcus-Alexander Wörns, Peter Galle, Nisar Malek","doi":"10.1055/a-2189-8826","DOIUrl":"10.1055/a-2189-8826","url":null,"abstract":"","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139747528","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 trans-anal tube placement is a safe and helpful tool for colonic decompression: final results of a standardized single-centre retrospective assessment of 125 patients.","authors":"Andreas Horn, Manij Sabet, Florian Roghmann, Volker Meves, Martin Loss, Juergen Hochberger, Christoph Benckert, Andreas Wolfgang Berger","doi":"10.1055/a-1989-2062","DOIUrl":"10.1055/a-1989-2062","url":null,"abstract":"<p><strong>Objectives: </strong>Endoscopic trans-anal colonic decompression (ECD) may be requested in the case of massive colon distension, but evidence regarding success and safety issues remains scarce. The aim of this analysis is to examine the technical success, complications and clinical outcome in a large series of patients undergoing an ECD in various clinical scenarios. A standardized evaluation system was used to identify the pre-interventional risk parameters that might be helpful to guide clinical decision making.</p><p><strong>Methods: </strong>In this single-centre retrospective study, the modified Clavien-Dindo classification (CDC) was applied to assess technical success, complications and clinical outcome of 125 consecutive patients who underwent ECD between 2007 and 2020.</p><p><strong>Primary endpoint: </strong>post interventional 90-day mortality. Secondary endpoints: periprocedural complications (CDC event IV-V) and technical success rate. All Martin criteria for standardized reporting of complications were met. Uni- and multivariable analyses for prediction of complications were carried out.</p><p><strong>Results: </strong>The overall technical success rate was 90%. The periprocedural complication rate was low with 3%. Overall 90-day mortality was 31%. Univariable analyses showed a significant correlation between 90-day mortality and ASA≥4 (p<0.001, odds ratio [OR] 15.33), general anaesthesia (p=0.05, OR 21.42) and elevated serological infection parameters (p 0.028, OR 1.004). The pre-interventional multivariable model identified ASA ≥4 (p <0.001; OR 10.94) as the only independent risk factor.</p><p><strong>Conclusions: </strong>ECD is a safe, easily available, technical feasible, inexpensive and successful tool for colonic decompression in various colonic obstruction scenarios, even in critically ill patients. ASA Score ≥IV can be helpful to identify patients at risk for complications/mortality after ECD.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9117824","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":"Symptoms and Management of Aseptic Liver Abscesses.","authors":"Susanne Hafner, Thomas Seufferlein, Alexander Kleger, Martin Müller","doi":"10.1055/a-2075-5082","DOIUrl":"10.1055/a-2075-5082","url":null,"abstract":"<p><p>Aseptic liver abscesses occur very rarely. Clinical guidelines on the management of the disease do not exist, and the diagnosis is challenging.We screen MEDLINE and PUBMED databases for relevant case reports from inception to November 2022. Information on patient age, sex, initial symptoms, the extent of abscess formation, further diagnoses, treatment, and course of the disease is analyzed.Thirty cases with sterile hepatic abscess formation are identified. In most patients (n=18), the spleen is affected as well. Patients typically present with fever, abdominal pain, and increased inflammatory values. Comorbidity with inflammatory bowel disease is very common (n=18) and is associated with a significantly younger age at the time of hepatic abscess development. In addition, many patients show autoimmune-mediated cutaneous, ocular, or arthritic rheumatoid manifestations. Histological examination of abscess material reveals neutrophilic infiltration. The majority of patients initially receive corticosteroid therapy. Furthermore, response to azathioprine, anti-TNF-α antibodies, and other immunomodulatory drugs is reported. Ten out of fourteen patients with a long-term follow-up (≥ 36 months) have at least one relapse of hepatic abscess formation.Aseptic hepatic abscesses should be considered in the case of sterile punctures and non-response to antibiotics. Patients with aseptic liver abscesses have a high risk of recurrence warranting immunomodulatory maintenance therapy.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41214438","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":"[Green endoscopy - strategy for more sustainablility in endoscopy].","authors":"Axel Eickhoff, Martin Goetz","doi":"10.1055/a-2150-9311","DOIUrl":"10.1055/a-2150-9311","url":null,"abstract":"<p><p>Climate protection, ecology and CO₂ neutrality have been discussed intensively and increasingly in society for years. This is also becoming increasingly important in hospitals and other medical facilities. The health care sector is responsible for 5.6% of all CO₂ emissions in Germany, particularly due to high energy consumption and a daily waste production of 6kg per patient. The following article summarizes the options for endoscopy to contribute to ecological sustainability, with a special focus on measures that can be easily implemented today.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139747527","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":"[49-year-old female patient with right-sided abdominal pain].","authors":"Achim Jatkowski, Arne Dehling, Wolfram Zoller","doi":"10.1055/a-2058-9094","DOIUrl":"10.1055/a-2058-9094","url":null,"abstract":"","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139747526","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":"Update S2k-Guideline Helicobacter pylori and gastroduodenal ulcer disease of the German Society of Gastroenterology, Digestive and Metabolic Diseases (DGVS).","authors":"Wolfgang Fischbach, Jan Bornschein, Jörg C Hoffmann, Sibylle Koletzko, Alexander Link, Lukas Macke, Peter Malfertheiner, Kerstin Schütte, Dieter-Michael Selgrad, Sebastian Suerbaum, Christian Schulz","doi":"10.1055/a-2181-2225","DOIUrl":"10.1055/a-2181-2225","url":null,"abstract":"","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139747531","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}