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Background: Randomised trials have shown that banding ligation is superior to sclerotherapy, requiring fewer treatment sessions to achieve variceal eradication, and giving lower rebleeding and complication rates., Material and Methods: From November 1997 through December 1999, we have treated 22 patients with bleeding oesophageal varices with endoscopic banding ligation to obliterate the varices and prevent recurrent bleeding., Results: A total of 72 banding procedures have been performed using rubber bands. The varices have been obliterated in 14 patients requiring a median of 3.5 (range 2-8) procedures, which is in good agreement with other published data. Twelve of these patients have been observed for a median of six (range 1-19) months without signs of recurrent bleeding. One patient had a bleeding four months after the last ligation procedure; the varices were obliterated six weeks before. One patient had a recurrent bleeding between the first and second banding procedure. One patient bled from an oesophageal ulcer caused by a rubber band two weeks after the procedure. Otherwise no serious complications occurred., Interpretation: On the basis of our own experiences and published studies, we propose that endoscopic banding ligation should be the method of choice for elective treatment of bleeding varices.

The aim of this paper is to describe a simple, nonsurgical method for endoscopic placement of a nasojejunal feeding tube. A stylet inserted in the tube facilitates nasogastric intubation. A thread on the tip of the tube is grasped with a biopsy forceps inserted through an endoscope, and the tube can be placed in the distal part of the duodenum under direct endoscopic inspection. By means of a guide wire the tube can be pushed further to the desired position in the upper part of the jejunum. The endoscope can now be removed while pressure is exerted on the stylet, thus preventing the tube from dislocating. By this method, oral-nasal transfer of the tube is avoided, the tube is placed in the upper jejunum under direct endoscopic inspection, and the stylet inserted in the tube facilitates intubation and prevents it from dislocating when the endoscope is withdrawn.

Non-steroidal anti-inflammatory drugs can cause side effects in the large bowel. We describe two cases which illustrate some of the aspects associated with this problem, and briefly outline the different types of side effects encountered, and possible pathogenetic mechanisms. It is emphasized that non-steroidal anti-inflammatory drugs can cause exacerbation of quiescent colitis in patients with inflammatory bowel disease. The use of these drugs in such patients should be very restrictive. Non-steroidal anti-inflammatory drugs can also precipitate de novo colitis. They are also associated with collagenous colitis, non-gangrenous ischemic colitis, complications to diverticular disease, and ulceration of the colon.