Video
Video: Colonoscopy with indigocarmine chromoendoscopy
Presented by:
Gerhard Mayer, HSK Dr. Horst-Schmidt-Kliniken Wiesbaden, Germany; Hironori Yamamoto, Jichi Medical School, Kawachi, Japan; Pradeep Bhandari, Queen Alexandra Hospital Cosham, Great Britain
This is the case of a 70-year-old woman who has a history of multiple colonic polypectomies. The history of the resection specimen had revealed hyperplastic polyps and serrated adenomas. Altogether, this patient fulfills the diagnostic criteria of having a hyperplastic polyposis syndrome. This syndrome is associated with a significantly increased risk of colonic carcinomas, and, therefore, complete detection and resection of lesions at surveillance colonoscopy is mandatory.
Here, colonoscopy with indigocarmine chromoendoscopy is performed to detect serrated lesions in the right hemicolon. A complicated lesion at the appendiceal orifice is resected.
Take home messages:
- Hyperplastic polyposis is a syndrome that is associated with an increaesed risk of colorectal cancer.
- The typical findings are multiple flat serrated lesions with predominance in the right colon.
- In the hyperplastic polyposis syndrome we find both: true hyperplastic polyps as well as serrated adenomas.
- Chromoendoscopy with indigocarmine is helpful to identify and demarcate the lesions that do mostly have a flat phenotype.
- Resection of all lesions larger than 5 mm is strongly recommended.
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.
©2013 Elsevier. All rights reserved. Wirth the friendly assistance of Falk Foundation e.V., Freiburg.
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Bowel
Text:
Lichtenstein GR, Am J Gastroenterol. 2014;109(2):212–23
New data from the TREAT Registry: In patients with Crohn’s disease, age, disease duration, and smoking were independently associated with increased risk of malignancy. Although results for immunosuppressant use were equivocal, no significant association between malignancy and infliximab was observed.
Link:
http://www.drfalkpharma.de/index.php?L=1&id=20365#27736
Text:
Panaccione R, Gastroenterology. 2014;146(2):392–400
Not only in Crohn’s disease: Combination therapy with infliximab and azathioprine is superior to monotherapy with either agent in ulcerative colitis
Link:
http://www.drfalkpharma.de/index.php?L=1&id=20365#c27737
Text:
Bortlik M, Inflamm Bowel Dis. 2014;20(3):495–501
In pregnant women with inflammatory bowel disease, exposure to anti-TNF-a antibodies seems to be safe for growth and psychomotor development of their children.
Link:
http://www.drfalkpharma.de/index.php?L=1&id=20365#c27738
Liver
Biliary Tracts
Text:
Lens S, Liver Int. 2014;34(2):197–203
Combination treatment of bezafibrate and ursodeoxycholic acid is associated with marked decrease or normalization of alkaline phosphatase as early as 3 months in patients with primary biliary cirrhosis.
Link:
http://www.drfalkpharma.de/index.php?L=1&id=20365#c27739
Text:
Beinhardt S,Clin Gastroenterol Hepatol. 2014;12(4):683–9
Non-cirrhotic patients with Wilson disease who receive adequate therapy with chelators have a good long-term prognosis. However, cirrhosis increases the risk of death and liver disease.
Link:
http://www.drfalkpharma.de/index.php?L=1&id=20365#c27740
Text:
Everson GT, Gastroenterology. 2014;146(2):420–9
The all-oral, interferon-free, and ribavirin-free regimen of daclatasvir, asunaprevir, and BMS-791325 was well tolerated and achieved >90% rates of sustained virologic response at 12 weeks in patients with hepatitis C virus genotype 1 infection.
Link:
http://www.drfalkpharma.de/index.php?L=1&id=20365#c27741
Oesophagus
Stomach
Duodenum
Text:
Hsu PI, Helicobacter. 2014;19(1):74–9
The 10-day quadruple therapy comprising a proton-pump inhibitor, bismuth, tetracycline, and levofloxacin achieves a very high eradication rate for Helicobacter pylori infection after failure of sequential therapy.
Link:
http://www.drfalkpharma.de/index.php?L=1&id=20365#c27742
Text:
Ford AC, BMJ. 2014;348(7959):11; g3174
This study provides limited, moderate quality evidence that eradicating Helicobacter pylori reduces the incidence of gastric cancer in healthy asymptomatic Asian individuals. These data cannot necessarily be extrapolated to other populations.
Link:
http://www.drfalkpharma.de/index.php?L=1&id=20365#c27743
Text:
Zhou L, Am J Gastroenterol. 2014;109(4):535–41
Helicobacter pylori eradication rates with standard triple therapy (esomeprazole, amoxicillin, clarithromycin) and sequential therapy (esomeprazole, amoxicillin, clarithromycin, tinidazole) were compromised by antibiotic resistance. Sequential therapy may be suitable in regions with high prevalence of isolated clarithromycin resistance, but it is unsatisfactory when both clarithromycin resistance and metronidazole resistance are present.
Link:
http://www.drfalkpharma.de/index.php?L=1&id=20365#c27744
Pancreas
Text:
Buijs J, Pancreas. 2014;43(2):261–7
Autoimmune pancreatitis is successfully treated with corticosteroids. Low doses of prednisone (10–20 mg/day) may be equivalent to high doses (40–60 mg/day).
Link:
http://www.drfalkpharma.de/index.php?L=1&id=20365#c27745
Current Falk literature:
Radiodiagnostics of Gallstones
Authors: M. Sackmann, M. Lenhart
(36 pages)
Revised edition 2014
U44e
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