ABSTRACT
Crohn's disease is a chronic inflammatory bowel disease that can involve any portion of the gastrointestinal tract. Up to 74% of patients require surgery. However, although respective surgery improves the clinical situation, relapses is frequent in most cases. The aim of this clinical trial was to evaluate the profile of patient who received AZA after surgical treatment in order to prevent postoperative recurrence. This was a retrospective study including 17 patients with severe Crohn's disease attending our gastrointestinal unit from September 1998 to June 2004. Patients were eligible if they have severe Crohn's disease, undergoing curative surgical treatment and received azathioprine for the first time after surgery to prevent postoperative recurrence. The study population comprised 17 patients with Crohn's disease [10 men and 7 women; mean age, 27 years]. The Crohn's disease was ileo-colic in 10 cases with perineal manifestations for 2 patients and ileal in 7 cases. The indications for surgery were stenosis in 10 cases, fistula in 5 cases, perforation in 1 case and corticosteroid-resistance in 1 case. The median folio wing-up period was 40 months [9-80 months]. During this period, only 1 patient reported severe adverse event and discontinued treatment due to acute pancreatitis. 1 patient was lost to follow-up and 3 patients had moderate clinical relapse. Maintained remission was obtained for 12 patients. None of our patients had surgical relapse. The result of this study shows the effect of Azathioprine in preventing both clinical and surgical relapses in patients with Crohn's disease who have undergone surgery
ABSTRACT
We report 65 cases of MALT gastric lymphomas. HP was looked for with Giemsa and Whartin Starry stains. Immunohistochemistry was done with PAP method. Anti-HP treatment was used in 9 cases. 38 were of low grade of malignancy, 23 were high grade, 4 were high grade with a low grads component. The mean age was 51.5 years, the sex ratio 1.5. Epigastric pain was the most frequent feature [87.7 percent of cases]. Endoscopically, low grade lymphomas presented as unique or multiple ulcerations [55.3 percent of cases] with antral localization [52.6 percent of cases]. 60 percent of our patients were stage IE, of which 61 percent had low grade lymphoma, 18 percent were at stage 112E, 10 percent at stage III and 10 percent at stage IV. From 23 operated patients, 29 percent had early lymphoma which was low grads malignant in 71.5 percent of cases, and 71 percent had lymphomas which were wi-dely spread beyond the submucosa. HP was found in 63 percent of cases. Histologic regression of two early lymphomas of low grade malignancy was achieved after HP eradication