Der Internist
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All findings which arise in the context of radiological diagnostics, potentially affect the health of a subject but with no intention to detect the corresponding finding are considered to be incidental radiological findings (IF). The prevalence of IFs is increasing due to the wider use of modern imaging techniques, such as magnetic resonance imaging (MRI) and computed tomography (CT) in routine clinical practice and the inclusion of imaging, such as whole body MRI in large population-based cohorts. The reporting of radiological IFs can lead to further diagnostics and treatment. ⋯ The management of IFs in the setting of research studies differs depending on various factors, such as study design and health status of enrolled subjects. In general, IFs must be disclosed to the subject if the radiological IFs are potentially clinically relevant; however, subjects must also be protected from the consequences of false positive findings. This review article discusses radiological IFs in the setting of the clinical routine and research studies and provides a basic summary of the management recommendations for commonly occurring IFs.
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For many specific and nonspecific gastrointestinal symptoms, endoscopic diagnostic procedures play an important role. Gastroscopy and colonoscopy are easily available diagnostic and interventional procedures with low risk. The technical development of gastrointestinal endoscopy has led to an improvement in diagnostics and therapy. ⋯ Rare diagnoses usually require an individualized therapy. Unexpected diagnoses can take place during (not properly detected) or after an endoscopy (overlooked or newly appeared) occur. This overview deals with the question of how to minimize unexpected diagnoses and how to diagnose and treat incidental findings.