Falk Gastro Info 11/2014

Video

Endosonography with contrast medium for visualization and differential diagnosis of a pancreatic mass

Live endoscopy from the HSK Dr. Horst Schmidt Hospitals in Wiesbaden in collaboration with „Video Journal and Encyclopedia of GI Endoscopy“. Recording in the context of the Falk Symposium 185 „Interfaces and Controversies in Gastroenterology“ on October 3rd – 4th, 2012.

Presented by:

Erwin Günther, HSK Dr. Horst-Schmidt-Kliniken Wiesbaden, Germany

Summary:

This is the case of a 46-year-old patient in whom a 1 cm large intrapancreatic mass had incidentally been diagnosed by sonography 8 years previously. Since the patient had no clinical particulars, it was decided that a wait-and-see procedure with sonographic follow-up should be applied.

Here, the endosonographic visualization and characterization of the foci is shown and the differential diagnosis is discussed.

Take home messages:

Pancreatic neuroendocrine tumors are homogeneous, well vascularized and smoothly demarcated tumors.
The pancreatic duct proximal to the lesions is usually not dilated. A wait-and-see procedure with a sonographic follow-up examination is justified in tumors < 2 cm with typical characteristics.

Please switch on your loudspeakers!

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http://media.drfalkpharma.de/fileadmin/media/130502_EUS_bei_Pankreas_640_FINAL.mp4

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Bowel

Text:

Nyhlin N et al, Aliment Pharmacol Ther. 2014;39(9):963–72

Although considered to be in clinical remission, patients with microscopic colitis suffer from persisting symptoms such as abdominal pain, fatigue, arthralgia or myalgia several years after diagnosis.

Link:

http://www.drfalkpharma.de/index.php?L=1&id=18863#c26921

Text:

Brenner H et al, Gastroenterology. 2014;146(3):709–17

In a population-based case-control study, the risk of colorectal cancer was strongly reduced up to 10 years after colonoscopy for any indication. Risk was particularly low after screening colonoscopy, even for cancer in the right colon.

Link:

http://www.drfalkpharma.de/index.php?L=1&id=18863#c26920

Text:

Colombel JF et al, Clin Gastroenterol Hepatol. 2014;12(3):414–22

In an exploratory study of patients with moderate-to-severe ileocolonic Crohn’s disease who received adalimumab induction and maintenance therapy, patients achieving deep remission appeared to have better 1-year outcomes than those not achieving deep remission.

Link:

http://www.drfalkpharma.de/index.php?L=1&id=18863#c26922

Liver
Biliary Tracts

Text:

Kircheis G et al, Gastroenterology. 2014;146(4):961–9

Critical flicker frequency (CFF) distinguishes between patients with overt hepatic encephalopathy and without minimal or overt hepatic encephalopathy.

Link:

http://www.drfalkpharma.de/index.php?L=1&id=18863#c26923

Text:

Afdhal N et al, N Engl J Med. 2014;370(20):1889–98

Once-daily ledipasvir-sofosbuvir with or without ribavirin for 12 or 24 weeks was highly effective in previously untreated patients with hepatitis C virus genotype 1 infection (ION-1-Trial).

Link:

http://www.drfalkpharma.de/index.php?L=1&id=18863#c26924

Text:

Lawitz E et al,Lancet. 2014;383(9916):515–23

The fixed-dose combination of sofosbuvir-ledipasvir alone or with ribavirin has the potential to cure most patients with hepatitis C virus genotype 1 infection, irrespective of treatment history or the presence of compensated cirrhosis (LONESTAR-Trial).

Link:

http://www.drfalkpharma.de/index.php?L=1&id=18863#c26919

Oesophagus

Stomach

Duodenum

Text:

Filion KB et al, Gut. 2014;63(4):552–8

This study does not suggest an increased risk of proton-pump inhibitor use for hospitalization due to community-acquired pneumonia.

Link:

http://www.drfalkpharma.de/index.php?L=1&id=18863#c26925

Text:

Lund M et al, BMJ. 2014;348(7950):14;g1908

Treatment of young infants with macrolide antibiotics in the first 2 weeks after birth was strongly associated with infantile hypertrophic pyloric stenosis.

Link:

http://www.drfalkpharma.de/index.php?L=1&id=18863#c26926

Text:

Zhang S et al, Br J Cancer. 2014;110(9):2378–88

Both low-dose aspirin and non-aspirin cyclooxygenase inhibitors are associated with a reduced risk of neoplasia in patients with Barrett’s esophagus.

Link:

http://www.drfalkpharma.de/index.php?L=1&id=18863#c26918

Pancreas

Text:

Das SLM et al, Gut. 2014;63(5):818–31

Patients with acute pancreatitis often develop pre-diabetes and/or diabetes mellitus after discharge from hospital, and have a greater than 2-fold increased risk of diabetes mellitus over 5 years.

Link:

http://www.drfalkpharma.de/index.php?L=1&id=18863#c26917

Current Falk literature:

Falk Symposium report

IBD 2014 – Thinking Out of theBox

(36 pages)

FSR192e

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