These results show that SEPS are effective for the palliation of dysphagia in patients with esophageal malignancies. The immediate results are similar to those observed with SEMS, and the observed low rate of late obstruction suggests that their long-term efficacy might be superior to that of SEMS. This device warrants evaluation in a controlled prospective trial.

The Cliny PEG 13 CH can be placed safely in an endoscopically controlled introducer procedure with dual gastropexy. Long-term follow-up of the patients revealed only minor complications. Primary indication is given in patients in whom PEG placement using the pull-through technique is not possible.

Our results show that the Cliny PEG 13 is a safe technique and an alternative to other methods and surgical procedures in patients in whom a PEG was not applicable by means of the pull-through technique. Larger case numbers and the use in other patient collectives will have to prove these initial results.

Single-dose ceftriaxone 1 g is a effective prophylaxis against local and systemic infection after PEG and should be a part of a standard regimen.

Enteral nutrition has been increasingly used in clinical practice during the past decades. Today, nasogastric, nasoenteric, and transcutaneous gastric or enteral feeding tubes are well established as a routine endoscopic intervention. After clinical introduction of percutaneous endoscopic gastrostomy (PEG) in 1980, the sutureless ‘pull’ PEG has become a widespread endoscopic technique for transcutaneous gastric long-term nutrition. Multiple new techniques have been introduced since then, and today even long-term jejunal nutrition can be achieved with modified techniques. The introducer PEG (first reported in 1984) has not become an established procedure, but new techniques with an endoscopic gastropexy might be a more effective approach. To increase the qualitiy of life of the patients, skin-level devices were designed and successfully introduced in 1984. A new development has been the one-step feeding tubes which provide the patients with a permanent tube. The standard techniques for long-term enteral feeding, new developments of feeding tubes, and future concepts are discussed in this review.

Single dose ceftriaxone 1 g is an effective prophylaxis against local and systemic infection after PEG.

In spite of its high incidence, not much is known about the etiology of chronic urticaria. We performed gastroscopic evaluation of 10 patients in whom no cause for chronic urticaria had been found. In 8 of these 10 patients, Helicobacter pylori was identified in the gastric mucosa. The chronic urticarial lesions disappeared within a few days after starting therapy with amoxicillin and omeprazol.

In our experience with five cases of Crohn's disease of the esophagus, the endoscopic appearance has been demonstrated. Corresponding to the basic pathological changes, the findings are very different, but two stages may be differentiated: Stage I in which inflammatory changes predominate as a mild or more often erosive-ulcerative esophagitis. Stage II is a stenosing form similar to a peptic stenosis or to a stenosing tumor. The morphological changes are predominantly limited to the lower part of the esopha.gus with a tendency to extend to the proximal regions. The diagnosis may be established endoscopically only in special cases with shallow ulcerations within a normal mucosa or with cobble-stone relief whidi is usually seen in the colon. In all other cases, a specific macroscopical appearance of Crohn's disease of the esophagus does not exist and no specific differentiation is possible from other forms of esophagitis. Only by a combination of endoscopy, radiology and histology can the diagnosis be suspected. Guided biopsies are not able to confirm the diagnosis histologically. The exact diagnosis of Crohn's disease of the esophagus is only possible by histological examination of the resected esophagus.