Der Internist
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Case Reports
[Right upper abdominal pain, vomiting, weight loss and icterus in a 20-year-old male refugee].
Tuberculosis (TB) is one of the most common infectious diseases worldwide. The case of a 20-year old male refugee from Somalia, who initially presented with right-sided upper abdominal pain, vomiting, weight loss and jaundice with suspected cholecystitis is reported. In the course of further diagnostics, pyloric stenosis surprisingly appeared, which, like the cholestasis, was caused by compressing peripancreatic lymph nodes. Lymph node cytology finally showed evidence of caseating necrosis with evidence of TB pathogens.
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Gastrointestinal polyposis syndromes are the second most common cause of hereditary colorectal carcinomas after Lynch syndrome (hereditary non-polyposis colon cancer, HNPCC). The detection of a causal germline mutation in an affected family member serves for differential diagnosis, assessment of the recurrence risk and predictive testing of healthy individuals at risk. ⋯ Early detection and correct classification of polyposis is crucial for adequate prevention and therapy. Access to multidisciplinary expert centres is useful for the care of families.
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Review
[Endoscopic diagnosis, treatment, and follow-up of polyps of the lower gastrointestinal tract].
The endoscopic management of polyps of the lower gastrointestinal tract (l-GIT) has emerged in recent years as a result of numerous technological innovations. However, proven expertise and experience are essential. ⋯ Adequate characterization and treatment are essential for the appropriate management of l‑GIT polyps.
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Review
[Endoscopic diagnosis, treatment, and follow-up of polyps of the upper gastrointestinal tract].
Polyps occur significantly less frequently in the upper gastrointestinal tract compared to the lower gastrointestinal tract. They are usually incidental findings at esophagogastroduodenoscopy. A distinction is made between epithelial lesions and subepithelial tumors. ⋯ For subepithelial tumors, advanced procedures such as endoscopic submucosal dissection (ESD), submucosal tunneling endoscopic resection (STER), or endoscopic full-thickness resection are available. These procedures should primarily be performed at centers with appropriate expertise. Endoscopic follow-up is primarily determined by the tumor entity and the resection status.