Tumeur d'Abrikossoff de l'estomac : une localisation rarissime

La tumeur d'Abrikossoff ou tumeur à cellules granuleuses est une lésion rare, souvent unique et bénigne. L'âge de son diagnostic habituellement est compris entre 40 et 60 ans. Elle prédomine légèrement chez les femmes, notamment de race noire. Elle est de siège ubiquitaire et préférentiellement cervico-céphalique. La langue reste la localisation la plus fréquente avec 28% des cas. Les autres localisations sont beaucoup moins fréquentes. Nous rapportons le premier cas documenté au Congo Brazzaville, de localisation gastrique, suivi d'une revue de la littérature

The dynamics of bacteria population on the skin, throat, and gastrointestinal tract of HIV-seropositive patients

Background: The study determined bacteria population on the skin; throat; and gastrointestinal tract of human immunodeficiency virus (HIV)-seropositive patients and HIV seronegative controls at the baseline; 3 months; and 6 months; respectively; at Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC); Ile-Ife; Osun State; Nigeria and State Specialist Hospital; Akure; Ondo State; Nigeria between May and November; 2012. Materials and Methods: Seventy HIV-seropositive subjects and 51 HIV seronegative controls who attended the HIV clinics were recruited. Skin; throat; and rectal swabs were obtained from the participants using sterile cotton-tipped applicators introduced into thioglycollate broth and incubated at 37oC overnight. When growth was noticed; the broth culture was streaked on different bacteriologic media and the isolates were characterized by the standard methods and disc diffusion for antibiotic sensitivity. Results: The number of isolates cultured from the HIV-seropositive subjects was 934; with the distribution being 397; 326; and 211 at the baseline; 3 months; and 6 months; respectively. The distribution of 1;138 isolates cultured from 51 HIV-seronegative controls was 433; 354; and 351 at the baseline; 3 months; and 6 months; respectively. At the baseline among HIV-seropositive patients; the predominant isolates were Arcanobacterium haemolyticum; Pseudomonas aeruginosa (P. aeruginosa); and Bacillus cereus (B. cereus). However; Corynebacterium haemolyticum; Enterococcus faecalis; and Escherichia coli (E. coli) were predominant at 3 months while at 6 months; Corynebacterium haemolyticum and Corynebacterium diphtheriae had the highest frequency followed by Pseudomonas fluorescens (P. fluorescens). In the controls; Corynebacterium diphtheriae; Listeria monocytogenes; and Staphylococcus xylosus (S. xylosus) predominated at the baseline and at 3 months while at 6 months; B. cereus; S. xylosus; and Staphylococcus aureus (S. aureus) were prevalent. Multiple resistances were widespread among the isolates. Conclusion: A preponderance of opportunists was observed in the HIV-seronegatives but higher multiresistant strains in the HIV-seropositives; suggesting both groups live in an antibiotic pressurized environment

Upper Gastrointestinal Endoscopic Findings and Prevalence of Helicobacter Pylori Check for this Species in other Resources Infection among Adult Patients with Dyspepsia in Northern Tanzania

Dyspepsia is a common presenting complaint of various upper gastrointestinal disorders. The symptoms of causes of dyspepsia often overlap and this makes etiological diagnosis difficult. Endoscopy is the ideal procedure for identifying organic diseases of the foregut. Helicobacter pylori infection is associated with various upper gastrointestinal pathologies. A cross-sectional study was conducted to determine endoscopic findings and H. pylori status in two hundred and eight consecutive dyspeptic adult patients between June 2009 and April 2010 at Kilimanjaro Christian medical Centre; a referral and teaching hospital in northern Tanzania. The most commonly identified endoscopic findings were gastritis (61.10); Gastroesophageal reflux disease (GERD) (57); and Peptic ulcer disease (PUD) (24.1). Gastric cancer was identified in 6.7 of patients and all of them were aged 40 years and above (p=0.00). H. pylori infection was detected in 65 (n=130) of patients. H. pylori infection was present in 57 (n=24) of patients who were tested within six months after eradication therapy. Gastritis and duodenal ulcer were statistically significantly associated with H. pylori (p0.001). No association was found between GERD and H. pylori infection (p0.05). Gastritis; GERD; and PUD are the leading causes of dyspepsia. H. pylori infection is present in significant proportion of dyspeptic patients. Patients with Gastritis and PUD should undergo empirical eradication therapy if a confirmatory test is not available. Patients with dyspepsia who are over 40 years of age should undergo Endoscopy (EGD) for initial work up. Study on antimicrobial susceptibility pattern of H. pylori is recommended to guide choices for evidence based treatment option

Les cancers du tube digestif en chirurgie viscerale au CNHU-HKM de Cotonou

But : il s'agit d'une etude menee dans le but d'analyser le profil epidemiologique; les aspects cliniques et therapeutiques des cancers du tube digestif dans les cliniques universitaires de chirurgie viscerale du CNHUHKM de Cotonou. Methode : cette etude a ete retrospective sur une periode de 10 ans allant du 1er janvier 2000 au 31 decembre 2009. Resultats : La frequence hospitaliere des cancers du tube digestif a ete de 2;06. Il s'agissait de 98 sujets de sexe masculin (65;33) et 52 de sexe feminin (34;67) la sex-ratio est de 1;88. L'age moyen etait de 51;67 ans avec des extremes de 20 et 80 ans. Les localisations neoplasiques etaient par ordre decroissant de frequence: l'estomac (34;67); l'oesophage (30); le rectum (14); l'anus (12) et le colon (9;33). Les principaux facteurs de risque ont ete l'alcoolotabagisme pour le cancer de l'oesophage (33;33); l'alcoolisme (36;5) et l'infection a helicobacter pylori (21) pour le cancer de l'estomac. Dans le cas du cancer de l'anus; la serologie HIV etait positive chez 12;5des patients. Les adenocarcinomes constituaient le type histologique le plus frequent (54;67) mais au niveau de l'oesophage etde l'anus les carcinomes epidermoides predominaient respectivement dans 80et 66;7. Les patients etaient tous vus au stade III ou IV selon la classification TNM. Le traitement chirurgical etait surtout palliatif (98;32). La mortalite peri-operatoire etait de 21. La survie globale etait de 4;54a 3 ans et 0a 5 ans. Conclusion : la frequence des cancers du tube digestif en chirurgie souvent tardif. Leur traitement est plus souvent palliatif

Species Distribution and Antibiotic Resistance in Coagulase-negative Staphylococci Colonizing the Gastrointestinal Tract of Children in Ile-Ife; Nigeria

Purpose: The antimicrobial susceptibility of 149 coagulase-negative staphylococci (CoNS) isolates from faecal samples of children in Ile-Ife; Nigeria; was evaluated in order to determine their contribution to antimicrobial resistance in the community. Methods: The isolates were identified to the species level by conventional methods; and their susceptibility to 20 antibiotics was tested by disk diffusion and to vancomycin by agar dilution. Results: The species distribution was as follows: Staphylococcus epidermidis 45 (30.2); S. haemolyticus; 26 (17.5); S. capitis; 24 (16.1); S. xylosus; 11 (7.4); S. saprophyticus; 8 (5.4); S. warneri; 8 (5.4); S. hominis; 6 (4.0); S. schleiferi; 5 (3.3); S. lugdunensis; 3 (2.0) and S. capitis sub ureolyticus; 3 (2.0) and isolates from other CoNS species 10 (6.7). Resistance to the - lactam antibiotics was in excess of 50of the isolates tested whilst there was significant incidence of resistance to cotrimoxazole; chloramphenicol; tetracycline; erythromycin; fusidic acid and norfloxacin. The highest percentage of oxacillin resistance was found among S. haemolyticus (46.2) while the lowest was in S. capitis (8.3). Reduced susceptibility (MIC 4mg/L) to vancomycin was shown by both oxacillin-resistant and susceptible CoNS species. Conclusion: The gastrointestinal tracts of children could serve as a reservoir for antibiotic-resistant CoNS; some of which had reduced susceptibility to vancomycin

Lymphomes gastro-intestinaux au Togo : aspects epidemiologiques et histopronostiques

Le tube digestif est le site principal des lymphomes non hodgkinien extra ganglionnaires. Le but de notre travail etait de decrire l'epidemiologie et l'histopronostic des lymphomes gastro-intestinaux au Togo. Il s'est agi d'une etude retrospective portant sur 32 cas diagnostiques au Togo pendant 20 ans. Les lymphomes gastro-intestinaux constituent une affection peu frequente au Togo representant 5;6des cancers du tube digestif et survenant a un age moyen de 37 ans avec un sex-ratio H/F a 1;5. Au plan histologique; les lymphomes de grade intermediaire etaient les plus observes suivant la classification de la Working Formulation (62;6); alors que ce sont les lymphomes de MALT de haut grade de malignite qui predominaient suivant la classification d'Isaacson. Leur topographie preferentielle etait l'estomac (59des cas). L'etroitesse du plateau technique de notre Laboratoire d'Anatomie Pathologique pose d'enormes problemes diagnostiques de ces lymphomes

Colorectal carcinoma in Port Harcourt

Background: Colorectal carcinoma, the commonest malignant tumour of the gastrointestinal tract, is rather uncommon in Nigeria, occurring often at a relatively early age. Aim: To report experience with colorectal carcinoma in the University of Port Harcourt Teaching Hospital (UPTH). Methodology: Patients treated for colorectal cancer at the UPTH over a 19- year period (1987-2006) and had complete information, were studied. Data were collected from patients/' case notes, ward registers, theatre records and histopathology reports. The data were analyzed with respect to age, gender, clinical features and investigations. Other indices studied were treatment, postoperative complications, duration of hospital stay and outcome/mortality. Results: The records of 36 cases were available for study. Male to female ratio was 2:1. The 41-60 year age range recorded the highest number of cases (52.8%). Weight loss, change in bowel habit, rectal bleeding, and abdominal/rectal mass constituted the main symptoms. Diagnosis was made from clinical examination, double contrast barium enema and proctosigmoidoscopy/biopsy. The rectum and caecum/ascending colon were commonly affected. The appropriate surgical treatment was duly performed. Some patients had postoperative adjuvant treatment using 5-fluorouracil only. Postoperative complications included surgical site infection, persistent perineal discharge, perineal pain, and obstruction of colostomy, hepatic encephalopathy and obstructive uropathy. The average duration of hospital stay was 12 days and follow-up assessment ranged from 3 months to 14 years. The postoperative mortality at three years was high. Conclusion: Colorectal carcinoma is relatively uncommon in our environment. The younger age groups tend to be more affected. Late presentation resulted in poor survival in spite of surgical treatment and adjuvant therapy

Spontaneous Neonatal Gastrointestinal Perforation : Surgical or Conservatisme Management

B a c k g r o u n d : S p o n t a n e o u s n e o n a t a l gastrointestinal perforation occurs without any primary lesion of the gastrointestinal tract. It is a rare surgical emergency that may be caused by shunting of blood from renal; peripheral and mesenteric vascular bed to vital organs such as heart and brain during periods of perinatal stress.Aim: To report three neonates with spontaneous gastrointestinal perforation. Results: Between 2001 and 2005; we managed three cases of spontaneous gastrointestinal perforation in neonates at the University of Benin Teaching Hospital; Benin City. The perinatal stress factors were caesarian delivery; prematurity and fetal distress due to prolonged obstructed labour. Two had exploratory laparotomy and their perforations were closed in 2 layers while one was managed conservatively. They survived and were discharged after ten; thirty-six and eight days on admission and remained well during one year of follow up.Conclusion: Early diagnosis; adequate resuscitation and timed surgical intervention resulted to encouraging outcome

Induced gastrointestinal tract (GIT) derangement following a long-term administration of a non-selective cyclooxygenase inhibitor-paracetamol in pregnant Sprague-Dawley Rats

There are two recognized isoforms of cyclooxygenase enzymes; the cyclooxygenase - 1 and cyclooxyg-enase - 2; the former is involved in the biosynthesis of prostaglandins; in organs where these eicosanoids play certain protective roles in the gastrointesional tract (GIT) and the kidney; it also enhances mucus secretions and acts as a house keeping enzyme expressed constitutively in most tissues of the body; while cyclooxygenase - 2 is the inducible form expressed in response to proinflammatory cytokines and growth factors; indicating a role in inflammation and growth and also maintains haemodynamics. In pregnant state; several drugs are used out of necessity; despite their reported toxicity. The clinical conditions often necessitating the use of non-selective cyclooxygenase inhibitors during pregnancy include hypertension; thromboembolism; hyperthyroid-ism; epilepsy; diabetes mellitus; preterm labour; arthritis; pain and fever; among others. The aim of this study was to investigate the induced gastrointestinal derangement following a long-term administration of paracetamol in pregnant Sprague-dawley rats. Twenty female adult Sprague-dawley rats weighing between 160g - 180g (as the beginning of the experiment) were used for the study. The animals were randomly divided into two groups (A and B) of ten rats each. Group A animals received distilled water orally and served as control. While paracetamol treated animals (group B) received doses of 7.3mg/kg/day respectively by gavage. The animal weights were monitored at an interval of three days before gestation to 13th day after parturition. The animals were allowed feed and water liberally. Drug administration commenced from 10th day of gestation to the end of parturition. On the 13th day after parturition the maternal rats were then sacrified for tissue processing. The results showed that the control animals had a normal architecture of the gastrointestinal tract. While the paracetamol treated animals showed a general derangement coupled with high degree inflammation of the stomach and intestinal lining; and a statistical significant weight loss (P0.005) compared to the control animals. These findings reflect gastrointestinal tract impairment. We conclude that a long-term use of non-selective cyclooxygenase inhibitor - paracetamol in pregnant state has an erosive effect on the gastrointestinal tract and may possibly be the aftermath of gastrointestinal tract inflammation in women

Induced Gastrointestinal Tract (GIT) Derangement Following a Long-Term Administration of a Non-Selective Cyclooxygenase Inhibitor - Paracetamol in Pregnant Sprague-Dawley Rats

There are two recognized isoforms of cyclooxygenase enzymes; the cyclooxygenase - 1 and cyclooxyg-enase - 2; the former is involved in the biosynthesis of prostaglandins; in organs where these eicosanoids play certain protective roles in the gastrointesional tract (GIT) and the kidney; it also enhances mucus secretions and acts as a house keeping enzyme expressed constitutively in most tissues of the body; while cyclooxygenase - 2 is the inducible form expressed in response to proinflammatory cytokines and growth factors; indicating a role in inflammation and growth and also maintains haemodynamics. In pregnant state; several drugs are used out of necessity; despite their reported toxicity. The clinical conditions often necessitating the use of non-selective cyclooxygenase inhibitors during pregnancy include hypertension; thromboembolism; hyperthyroid-ism; epilepsy; diabetes mellitus; preterm labour; arthritis; pain and fever; among others. The aim of this study was to investigate the induced gastrointestinal derangement following a long-term administration of paracetamol in pregnant Sprague-dawley rats. Twenty female adult Sprague-dawley rats weighing between 160g - 180g (as the beginning of the experiment) were used for the study. The animals were randomly divided into two groups (A and B) of ten rats each. Group A animals received distilled water orally and served as control. While paracetamol treated animals (group B) received doses of 7.3mg/kg/day respectively by gavage. The animal weights were monitored at an interval of three days before gestation to 13th day after parturition. The animals were allowed feed and water liberally. Drug administration commenced from 10th day of gestation to the end of parturition. On the 13th day after parturition the maternal rats were then sacrified for tissue processing. The results showed that the control animals had a normal architecture of the gastrointestinal tract. While the paracetamol treated animals showed a general derangement coupled with high degree inflammation of the stomach and intestinal lining; and a statistical significant weight loss (P0.005) compared to the control animals. These findings reflect gastrointestinal tract impairment. We conclude that a long-term use of non-selective cyclooxygenase inhibitor - paracetamol in pregnant state has an erosive effect on the gastrointestinal tract and may possibly be the aftermath of gastrointestinal tract inflammation in women