As population-wide screening for colorectal cancer is adopted by many western countries for all individuals aged 50-75. The success of screening colonoscopy programs is highly dependent on the quality of the procedures. High-quality complete endoscopy with excellent patient preparation and adequate withdrawal time is necessary for effectively reducing colon cancer risk. In Belgium formal quality assurance programs and principles of credentialing do not exist. The current reimbursement system for colonoscopy does not reward a careful performed examination but rapidly performed examinations at unnecessarily short intervals. There is a clear need for evidence-based quality measures to ensure the quality of screening colonoscopy. In this guideline review we present an overview of the literature concerning criteria for best practice and important quality indicators for colonoscopy. A summary of the latest guidelines is given. Our goal of this update is to provide practical guidelines for endoscopists performing screening colonoscopy. We hope to provide a broad consensus and an increasing adherence to these recommendations.

SummaryIn 10 patients with benign gastric mesenchymal tumors, the most relevant clinical characteristics are reviewed. Bleeding, obstruction or risk of degeneration warrant a thorough investigation. Endoscopy is the most important diagnostic procedure. The benign aspect of these tumors is easily recognised; due to their submucosal growth, seldom a positive biopsy is obtained. Surgery is the treatment of choice.

SummaryTwo cases of type V hyperlipoproteinemia in monozygotic twin-brothers are described. Hyperlipemia was associated with recurrent attacks °f abdominal pain, bouts of chronic relapsing Pancreatitis, thrombosis of the splenic vein, splenomegaly and segmental portal hypertension.One patient died following a drainage operaion of a pancreatic abscess. Early recognition °f the disease and appropriate treatment may Prevent useless surgical intervention.A family study was undertaken and three addional case of type IV hyperlipoproteinemia were found.

In a family, of which 32 members belonging to three generations could be examined, 21 subjects were normal, while 11 were affected by hyperlipoproteinaemia types IV and V or related biological disorders. Neither an autosomal dominant inheritance nor an autosomal recessive inheritance nor a multiple-type hyperlipoproteinaemia can unreservedly be accepted.