Falk Gastro Info 10/2021

Video course abdominal ultrasound

Examination of the abdominal vessels – Superior mesenteric artery, spectral analysis

Author: Prof. Dr. Christoph F. Dietrich ©2019 Falk Foundation e.V., Freiburg. All rights reserved.

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Latest research in brief:

Bowel

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Kanis SL et al, Gut. 2021;70(7):1266–74
Health outcomes of 1000 children born to mothers with inflammatory bowel disease: This study involving 1000 children confirms that in utero exposure to thiopurines or TNF antibodies did not affect health outcomes of children during their first 5 years of life.

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Chey WD et al, Am J Gastroenterol. 2021;116(6):1294–303
Novel therapy for patients with irritable bowel syndrome with constipation (IBS-C): Tenapanor, a first-in-class minimally absorbed inhibitor of the apical Na+/H+ exchanger NHE3 improved IBS-C symptoms significantly better than placebo over 26 weeks and was well tolerated with mild diarrhea being the most common adverse event.

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van Hattem WA et al, Gut. 2021;70(9):1691–7
Endoscopic management of large sessile serrated lesions (SSL): Piecemeal cold snare polypectomy of large SSL was technically equally efficacious to endoscopic mucosa resection in a historical comparison but virtually eliminated the risk of delayed bleeding and perforation.

Link to text Liver Biliary Tracts

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Tanaka A et al, J Hepatol. 2021;75(3):565–71
Primary biliary cholangitis (PBC): In a large retrospective Japanese nationwide cohort study, the addition of bezafibrate to ursodeoxycholic acid was associated with improved prognosis. The number needed to treat to prevent 1 additional death or liver transplantation over 10 years was 14 (95% confidence interval: 10–22).

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Martínez J et al, J Hepatol. 2021;75(2):342–50
Variceal bleeding in cirrhosis: Bacterial infections develop in almost one-fifth of patients with acute variceal bleeding despite antibiotic prophylaxis. Respiratory infection is the most frequent, is an early event after admission, and is associated with advanced liver failure, severe hepatic encephalopathy and the use of nasogastric tube, orotracheal intubation for endoscopy or esophageal balloon tamponade.

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Rabinowich L et al, J Hepatol. 2021;75(2):435–8
COVID-19 vaccine response in liver transplant recipients: In a current study from Israel liver transplant recipients showed a substantially inferior vaccine response to the Pfizer-BioNTech SARS-CoV-2 mRNA-based vaccine compared to immunocompetent individuals (approx. 50% positive antibody detection; if antibodies were detectable, their titer was approx. 50% reduced compared to immunocompetent individuals). Older age, impaired renal function, and immunosuppressive therapy with high-dose steroids or mycophenolate mofetil were predictors for a negative response.

Link to text Oesophagus Stomach Duodenum

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Nyssen OP et al, Am J Gastroenterol. 2021;116(6):1220–9
Adverse event profile during eradication therapies for Helicobacter pylori: Results of an European prospective registry involving more than 22.000 patients indicate that eradication therapies frequently induce adverse events which are usually mild and of limited duration. Their appearance does not interfere significantly with treatment compliance.

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Sun JM et al, Lancet. 2021;398(10302):759–71
Pembrolizumab plus chemotherapy as first-line therapy for advanced esophageal cancer: A phase 3 trial reports that pembrolizumab plus chemotherapy as compared to placebo plus chemotherapy resulted in a meaningful improvement of overall and progression-free survival in patients with esophageal squamous cell carcinoma, patients with a PD-L1 immunoscore ≥ 10 and in all randomized patients regardless of histology. The safety profile was manageable.

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Thosani N et al, Am J Gastroenterol. 2021;116(9):1868–75
Bleeding risk associated with uninterrupted antithrombotic therapy during percutaneous endoscopic gastrostomy (PEG): A cohort study involving more than 1500 patients suggests that risk of significant bleeding and mortality following PEG placement was minimal in patients with uninterrupted periprocedural antithrombotic therapy.

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Crinò SF et al, Gastroenterology. 2021;161(3):899–909.e5Rapid on-site evaluation (ROSE) for diagnosis of solid pancreatic lesions: Endoscopic ultrasound-guided biopsies (EUS-FNB) without ROSE demonstrated high diagnostic accuracy independently on execution of ROSE in a randomized trial. When new-generation FNB needles are used, ROSE should not be routinely recommended.

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Abdominal Imaging in Gastroenterology and Hepatology

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Current Falk literature:

Microscopic colitis – Collagenous and lymphocytic colitis

Relevance, Interpretation, Algorithms, and Disease Specifics
Author: A. Tromm, Hattingen
(54 pages)
BU6E