Systemic inflammatory response and thrombosis due to alterations in the gut microbiota in COVID-19.

We thank Dr. Cienfuegos and colleagues for their comments on our recent publication "COVID-19, Coronavirus, SARS-CoV-2 and the small bowel". Cienfuegos et al.

COVID-19, coronavirus, SARS-CoV-2 and the small bowel.

Although SARS-CoV-2 may primarily enter the cells of the lungs, the small bowel may also be an important entry or interaction site, as the enterocytes are rich in angiotensin converting enzyme (ACE)-2 receptors. The initial gastrointestinal symptoms that appear early during the course of Covid-19 support this hypothesis. Furthermore, SARS-CoV virions are preferentially released apically and not at the basement of the airway cells.

Direct percutaneous endoscopic jejunostomy - Should we move on to single- and double-balloon enteroscopy techniques?

Direct percutaneous endoscopic jejunostomy (DPEJ) is a useful technique to access the jejunum in order to: a) provide enteral nutrition to individuals when the gastric route is absent or contraindicated; and b) to decompress the jejunum in patients with malignant small bowel obstruction. Traditionally, DPEJ is performed using a colonoscope or enteroscope, which is advanced as deep as possible into the jejunum. The insertion technique of the feeding tube is identical to the one used for a gastrostomy tube (Ponsky-Gauderer method).

The impact of high-resolution ultrasound in the differential diagnosis of non-hemolytic jaundice.

Because jaundice is a common reason for hospital admission. A fast and correct differential diagnosis is very important to increase treatment efficacy. The aim of our study was to evaluate the impact of the high-resolution ultrasound in this kind of clinical setting.

Impact of high-resolution transabdominal ultrasound in the diagnosis of complications of Crohn's disease.

Objective: Crohn's disease is associated with intestinal complications such as strictures, fistulas and abscesses. As the management of the patients is influenced by the presence or absence of complication, sensitive diagnostic modalities to detect these complications are needed. The aim of this prospective study was to evaluate the diagnostic accuracy of high-resolution transabdominal ultrasound in the diagnosis of complications of Crohn's disease.

A 'double-balloon enteroscopy worth the money': endoscopic removal of a coin lodged in the small bowel.

Double-balloon enteroscopy (DBE) has become the standard endoscopic method to diagnose and treat disorders of the small bowel. The most common therapeutic applications of DBE are hemostasis, polypectomy and stricture dilation. DBE has also been used to place stents in the small bowel and to retrieve foreign bodies such as retained capsule endoscopes.

[Diagnostic and therapeutic utility of double balloon endoscopy: experience with 225 procedures].

Introduction: Double balloon enteroscopy (DBE) is a new endoscopic method for the examination of the small intestine.

Objective: To determine the diagnostic yield and therapeutic utility of DBE.

Patients And Methods: All patients undergoing DBE using a Fuji-non intestinoscope for suspected small bowel diseases during a 2 1/2 year period were studied in a prospective single-center cohort study.

Contrast-enhanced sonography in pancreatic diseases.

Contrast-enhanced sonography is a widely available imaging modality for the diagnosis of pancreatic diseases. With this procedure, pancreatic tumours can be differentiated better. Furthermore, contrast-enhanced sonography produces good results in the staging of acute pancreatitis severity, especially in the detection of pancreatic necrosis.

Acute severe pancreatitis: contrast-enhanced sonography.

Early assessment and differentiation of oedematous acute pancreatitis and necrotizing or severe acute pancreatitis allow distinct therapeutic algorithms. Spiral computed tomography is currently considered the gold standard for staging of acute severe pancreatitis. Conventional transabdominal ultrasound plays only a limited role in the staging of acute pancreatitis.

Contrast-enhanced ultrasound in the diagnosis of pancreatic tumors.

Echo-enhanced ultrasound is a newly available imaging modality for the evaluation of pancreatic lesions. Neoplasms of the pancreas tend to have a characteristic vascularization pattern. Adenocarcinomas are often hypovascularized as compared to the surrounding tissue.

Small bowel obstruction in pregnancy.

Background: Intestinal obstruction in pregnancy is rare. Symptoms are often unspecific and a high level of suspicion is essential for early diagnosis. Fetal and maternal mortality rates are higher during pregnancy due to delay in diagnosis.