Contrast-enhanced ultrasound (CEUS) has excellent diagnostic accuracy in differentiating focal liver lesions: results from a Swiss tertiary gastroenterological centre.

Introduction: Focal liver lesions (FLLs) are common on conventional ultrasound. Contrast-enhanced ultrasound (CEUS) is highly accurate for differentiating between benign and malignant FLLs, with an accuracy comparable to that of contrast-enhanced CT and contrast-enhanced MRI. Notably, there is no evidence supporting the routine use of CEUS for evaluating benign and malignant FLLs in Switzerland.

Effect of morbid obesity, gastric banding and gastric bypass on esophageal symptoms, mucosa and function.

Background: Obesity and gastroesophageal reflux disease (GERD) are commonly associated diseases. Bariatric surgery has been shown to have various impacts on esophageal function and GERD. Our aim was to evaluate changes in symptoms, endoscopic findings, bolus passage and esophageal function in patients after primary gastric bypass surgery as compared to patients converted from gastric banding to gastric bypass.

Endoscopic dilation of complete oesophageal obstructions with a combined antegrade-retrograde rendezvous technique.

Aim: To investigate the combined antegrade-retrograde endoscopic rendezvous technique for complete oesophageal obstruction and the swallowing outcome.

Methods: This single-centre case series includes consecutive patients who were unable to swallow due to complete oesophageal obstruction and underwent combined antegrade-retrograde endoscopic dilation (CARD) within the last 10 years. The patients' demographic characteristics, clinical parameters, endoscopic therapy, adverse events, and outcomes were obtained retrospectively.

The role of single-balloon colonoscopy for patients with previous incomplete standard colonoscopy: Is it worth doing it?

Background: The rate of cecal intubation is a well-recognized quality measure of successful colonoscopy. Infrequently, the standard colonoscopy techniques fail to achieve complete examination. The role of single-balloon overtube-assisted colonoscopy (SBC) in these situations has only been sparsely studied.

Prospective Swiss pilot study of Endocuff-assisted colonoscopy in a screening population.

Background And Study Aims: The adenoma detection rate (ADR) is one of the quality measures in screening colonoscopy and is crucial for reducing colorectal cancer morbidity and mortality. Up to 25 % of adenomas are missed during colonoscopy. Endocuff is an easy-to-use device that is attached like a cap to the distal tip of the colonoscope in order to optimize visualization behind the folds of the colon and increase the ADR.

Mind the sump! - diagnostic challenge of a rare complication of choledochoduodenostomy.

Sump syndrome is a rare long-term complication of side-to-side choledochoduodenostomy (CDD), a common surgical procedure in patients with biliary tract disease in the era before endoscopic retrograde cholangiopancreatography (ERCP). Frequently only pneumobilia, serving as sign for functioning biliary-enteric anastomosis, is reminiscent of the former surgery. We present the case of an 81-year-old patient with sump syndrome who presented with clinical signs of ascending cholangitis, decades after the initial CDD procedure.

Multipurpose use of the over-the-scope-clip system ("Bear claw") in the gastrointestinal tract: Swiss experience in a tertiary center.

Aim: To evaluate the outcome of over-the-scope-clip system (OTSC) for endoscopic treatment of various indications in daily clinical practice in Switzerland.

Methods: This prospective, consecutive case series was conducted at a tertiary care hospital from September 2010 to January 2014. Indications for OTSC application were fistulae, anastomotic leakage, perforation, unroofed submucosal lesion for biopsy, refractory bleeding, and stent fixation in the gastrointestinal (GI) tract.

First report of colonoscopic closure of a gastrocolocutaneous PEG migration with over-the-scope-clip-system.

Percutaneous endoscopic gastrostomy (PEG) is a common practice for long-term nutrition of patients who are unable to take oral food. We report of an 85-year old man with a history of recurrent larynx carcinoma and hemicolectomy many years ago due to unknown reason. Laryngectomy was indicated.

Unspecific abdominal symptoms and pneumobilia: a rare case of gastrointestinal obstruction.

The case of a 77-year-old woman with symptoms of gastric outlet obstruction is presented. Transabdominal ultrasonography findings were suspicious of Bouveret's syndrome. Upper endoscopy confirmed this diagnosis.

Routine use of Hemospray for gastrointestinal bleeding: prospective two-center experience in Switzerland.

Hemospray (Cook Medical, Winston-Salem, North Carolina, USA) is a hemostatic agent recently introduced for the management of upper gastrointestinal bleeding (GIB). To date, there is little experience with this fairly new hemostatic tool. The aim of this case series was to reflect the use and effectiveness of Hemospray as a treatment option in GIB in everyday clinical practice at two tertiary referral centers.

[Malignant hypoglycaemia].

We describe the case of a 19-years old patient with seizure due to severe hypoglycaemia during general practitioner consultation. Because of hyperinsulinaemic hypoglycaemia and suspected liver metastasis a neuroendocrine hormone active tumor was suspected. After liver biopsy and CT scan a neuroendocrine pancreatic tumor could be diagnosed.

Perception of preference and risk-taking in laparoscopy, transgastric, and rigid-hybrid transvaginal NOTES for cholecystectomy.

Questions Under Study: Few data are available regarding patients' perceptions of new cholecystectomy (CC) techniques, in the context of the patients' risk behaviours. We investigated patients' preferences for transgastric pure natural orifice translumenal endoscopic surgery (NOTES; transgastric NCC) and rigid-hybrid transvaginal NOTES CC (tvNCC) compared with the standard laparoscopic CC (SL-CC), and patients' risk behaviours.

Methods: A total of 140 inpatients scheduled for elective laparoscopic CC were enrolled in this prospective single-centre study, from January 2009 to January 2010.

How is the increased risk of colorectal cancer in first-degree relatives of patients communicated?

Objectives: Compared with the general population, first-degree relatives (FDRs) of colorectal cancer (CRC) patients have a two-fold to four-fold higher risk of developing CRC. Little data is available regarding communication between doctors and CRC patients about risk to FDRs. We aimed to evaluate CRC patients' knowledge of FDRs' increased CRC risk, and FDRs' knowledge of this risk and adherence to CRC screening.

[Non-cirrhotic portal hypertension with nearly lethal consequences].

We describe the case of a 48-year-old patient presenting with abdominal pain with a history of cerebral ischemia due to a patent foramen ovale with heterozygous factor V mutation. Initial work-up demonstrate a significant thrombosis of the portal venous system combined with signs of portal hypertension (ascites, oesophageal varices). Ultrasound reveals no signs of cirrhosis of the liver.

Predictors for hospitalization and outpatient visits in patients with inflammatory bowel disease: results from the Swiss Inflammatory Bowel Disease Cohort Study.

Objectives: Patients with inflammatory bowel disease (IBD) have a high resource consumption, with considerable costs for the healthcare system. In a system with sparse resources, treatment is influenced not only by clinical judgement but also by resource consumption. We aimed to determine the resource consumption of IBD patients and to identify its significant predictors.

Predictors of temporary and permanent work disability in patients with inflammatory bowel disease: results of the swiss inflammatory bowel disease cohort study.

Background: Inflammatory bowel disease can decrease the quality of life and induce work disability. We sought to (1) identify and quantify the predictors of disease-specific work disability in patients with inflammatory bowel disease and (2) assess the suitability of using cross-sectional data to predict future outcomes, using the Swiss Inflammatory Bowel Disease Cohort Study data.

Methods: A total of 1187 patients were enrolled and followed up for an average of 13 months.

[Liver failure in a 27 years old female patient].

We report about a 27-years old female patient with acute liver failure due to an acute Budd Chiari Syndrom (thrombosis of all three liver veins an vena cava inferior) with caval web, birth control pills and after long distance flight. After successfull aspiration of the caval thrombus and dilatation of caval web liver transplantation could be bypassed. Two weeks after intervention the patient was in a good healthy condition with normal laboratory values, normal liver size, normal perfusion of the V.

[An uncommon cause of iron deficiency anemia].

A 55-year-old patient was diagnosed having a malignant melanoma metastatic to the small bowel as cause of an iron deficiency anemia. Although up to 60% of patients with metastatic melanoma are found to have intestinal metastases at autopsy, clinically apparent gastrointestinal involvement is rare during lifetime and often delayed after resection of the primary tumor. Diagnostic procedures include radiological imaging and endoscopic modalities.

Malignant biliary stenosis: conventional cytology versus DNA image cytometry.

Background: The aim of this study is to evaluate the utility of image cytometry (ICM)-DNA analysis on cytological brush specimens in improving the sensitivity and diagnostic accuracy for biliary neoplasias.

Methods: A total of 71 patients with 89 samples of biliary tree brushing from a stenosis were included in this prospective study. Conventional cytology (CC) and DNA ploidy using ICM of the brushing were performed.

Endosonographic radial tumor thickness after neoadjuvant chemoradiation therapy to predict response and survival in patients with locally advanced esophageal cancer: a prospective multicenter phase ll study by the Swiss Group for Clinical Cancer Research (SAKK 75/02).

Background: EUS response assessment in patients with locally advanced esophageal cancer undergoing neoadjuvant chemoradiation therapy (CRT) is limited by disintegration of the involved anatomic structures.

Objective: Predictive and prognostic values of a prospectively defined maximum tumor thickness (MTT).

Design: Prospective open-label phase ll study (SAKK 75/02).

Evaluation of endoscopy in localizing transgastric access for natural orifice transluminal endoscopic surgery in humans.

Background: To date, transgastric access in humans for natural orifice transluminal endoscopic surgery (NOTES) has been poorly evaluated.

Objective: To compare endoscopic visualization of the transgastric access point with the laparoscopically defined ideal entrance to the peritoneal cavity.

Design: Prospective pilot study in humans.