Predictive Factors of Surgery in Peptic Stenosis of the Bulb

The bulb ulcer stenosis, becoming exceptional in developed countries, remains frequent in our country despite the use of the antisecretory. The purpose of our study was to study epidemiological, diagnostic, and evolutionary complication particularities, and to find potential predictive factors of resistance of ulcer stenosis of the bulb to the pump inhibitors Proton through a recent series. This is a retrospective and descriptive study involving 105 patients, treated for ulcer stenosis of the bulb between January 2007 and December 2012. All our patients had received inhibitors of Proton pump, parenterally for 7 days. They were divided into 2 groups according to their response to treatment: the first group (G1) was sensitive and the second (G2) was resistant. All patients of the G2 were operated. We had compared the two groups. There was no statistically significant difference concerning age, sex, blood group and smoking between the two groups. In univariate study, the age of the epigastralgies was greater than or equal to 9 years;the clapotage fasting, dilation and gastric atony, objectified by the oesogastroduodenal transit were significantly associated with the failure of medical treatment. Only gastric atony and seniority of the disease over 9 years were independent risk factors of resistance to the Proton pump inhibitors in multivariate study.

Role of Coelioscopy in the Etiologic Diagnosis of Exudative Ascites of Unknown Origin of the Women

Introduction: The aim of this study was to clarify the role of laparoscopy in the etiological diagnosis of exudative ascites of unknown origin in women. Materials and Methods: This?was?a prospective study from 2007 to 2012, including 83 women with exudative ascites of unknown origin and had a laparoscopy diagnostic purpose. Results: Carcinomatosis and peritoneal tuberculosis were the two most common causes found in 31% (26 cases) and 66% (55 cases) of cases respectively. The average age of the patients was 56 years. Weight loss and abdominal pain were the most frequent, observed symptoms in 71 cases (85.5%) and 53 cases (63.8%) respectively. The CT scan abnormalities noted?were a peritoneal thickening in 32 cases (38.5%), peritoneal nodules in 15 cases (18%), and agglutination of the digestive handles in 12 cases (14.4%). Laparoscopic Visual diagnosis was in favor of a peritoneal carcinomatosis in 32 cases (38.5%), peritoneal tuberculosis in 45 cases (54.2%), and non specific infection in 6 cases (7.3%). The histological diagnosis was a peritoneal carcinomatosis in 26 cases (31%), and peritoneal tuberculosis in 55 cases (66%). The positive predictive value of laparoscopic vision Diagnostics in Peritoneal tuberculosis was 100% and the negative predictive value was 73.7%. In peritoneal carcinomatosis, the positive predictive value was 81.3% and the negative predictive value was 100%. Conclusion: The etiologic diagnosis of exudative ascites in women is difficult despite the availability of several tests. Currently, laparoscopy with peritoneal biopsy remains the gold standard for etiologic diagnosis.

Azathioprine induced liver cirrhosis: An unusual side effect

In recent years, the hepatotoxic potential of thiopurines, in particular 6-thioguanine (6-TG), has been discussed in literature. However, cirrhosis was exceptionally reported. We report the case of a 56-year-old woman with ileocaecal Crohn’s disease treated with azathioprine. After taking azathioprine (2 mg/kg daily) for four years, she underwent surgical treatment for acute intestinal obstruction. In peroperative, we noticed a cirrhotic liver. A surgical biopsy was performed and the diagnosis of cirrhosis was confirmed. Autoimmune and viral liver diseases were ruled out by laboratory parameters. Therefore, Azathioprine is believed to be the causative factor for inducing liver cirrhosis. Thus, treating inflammatory bowel disease effectively while trying to limit iatrogenic disease is a continuous struggle.

Vogt-Koyanagi-Harada综合征与克罗恩病:一种独特的关系

Vogt-Koyanagi-Harada disease(VKH)is a rare,multisystem disease of melanocyte-containing organs.It is characterized by diffuse,granulomatous inflammation involving various organs.It has been reported to occur in association with other autoimmune disorders.We report the case of a female patient who was diagnosed with VKH at the age of 4 years and who was treated with corticosteroids until the age of 16.Twenty years later,Crohn’s disease was diagnosed,with a severe flare-up.Three cases of VKH associated with ulcerative colitis have previously been reported anecdotally but,to our knowledge,this is the first case occurring in association to Crohn’s disease.