ABSTRACT
Wandering or ectopic spleen is a condition characterised by migration of spleen in the abdomen or pelvis. This anomaly is rare, with a reported incidence of <0.2%. It occurs mostly in women between 20 and 40 years of age. Clinical diagnosis is difficult because of lack of precise signs, symptoms, and nonspecific laboratory data. Diagnosis of a wandering spleen highly depends on the results of imaging studies such as abdominal ultrasound and abdominopelvic computed tomography [CT] scanning. Treatment includes surgery with the choice between splenopexy in a noninfarcted spleen and splenectomy when infarction has occurred. We report a rare case of wandering spleen in a 27-year-old man with infarction due to torsion of its pedicle, which was diagnosed by CT and treated by splenectomy. Conclusion: Despite the rarity of wandering spleen, the possibility of torsion of its long pedicle with acute splenic infarction should be considered in the differential diagnosis of acute abdomen
ABSTRACT
An impaired lipid metabolism is often observed in patients with chronic liver diseases. This study was carried out to determine the lipid profile in cirrhotic patients with and without hepatocellular carcinoma [HCC] and to determine whether it relates to the severity of cirrhosis in Upper Egypt. In an analytical cross-sectional study, 74 patients with cirrhosis and 36 patients with cirrhosis and HCC [cases] and 65 age-matched and sex-matched healthy individuals [control] were studied from the Tropical Medicine and Gastroenterology Department and Internal Medicine Department, Assiut University Hospital. For all the participants, the following was carried out: clinical evaluation, abdominal ultrasound [US] examination, and laboratory investigations including the lipid profile [total cholesterol, triglycerides, low-density lipoprotein [LDL], and high-density lipoprotein [HDL]]. In cirrhotic patients with and without HCC, there was a significant decrease in serum total cholesterol, triglycerides, LDL, and HDL levels compared with the control group. Comparison of the lipid profile with the severity of cirrhosis indicated that serum cholesterol, triglyceride, and LDL but not HDL levels decreased linearly with progression of liver damage [Child C vs. Child A]. The HDL level was significantly lower in cirrhotic patients with HCC than in cirrhotic patients without HCC. The lipid profile [total cholesterol, triglycerides, HDL, and LDL levels] is impaired in cirrhotic patients with and without HCC. The lipid profile [but not HDL] is inversely correlated with the severity of cirrhosis. The HDL level is significantly lower in cirrhotic patients with HCC than in cirrhotic patients without HCC
ABSTRACT
Hepatocellular carcinoma [HCC] is the commonest primary cancer of liver. Epidcmiologic research exploring risk factors of HCC is important because of increasing frequency of the disease in Egypt with remarkable rise in noncirrhotic patients. Identifying risk factors of HCC may help in decreasing its incidence.This study was carried out to identify risk factors of HCC among both cirrhotic and noncirrhotic patients in Upper Egypt. A case control study of 104 cases with HCC against 104 controls without HCC were recruited from Tropical Medicine and Gastroenterology Department, Assiut University Hospital; patients were from the governorates of Assiut, Sohag, Qena, and Aswan. Patients were divided into two groups, cirrhotics and noncirrhotics. For all participants, the following was conducted: clinical evaluation, abdominal ultrasonography examination, and laboratory investigations. Risk factors of HCC were identified using univariate then multivariate analysis. Cirrhotic patients constituted 60.6% of the total sample while noncirrhotic patients constituted 39.4%. Among cirrhotic patients, higher risk of HCC was observed with underground water use [OR 15.825, 95% CI 4.462-56.128], tobacco smoking [OR 7.755, 95% CI 2.790-21.558], and metabolic syndrome [OR 5.595, 95% CI 1.565-20.009], While risk factors of HCC in noncirrhotic patients were found to be positive HBsAg [OR 15.223, 95% CI 2.009-115.352], tobacco smoking [OR 8.349, 95% CI 2.113-32.982], metabolic syndrome [OR 7.374, 95% CI 1.635-33.266], and manual agricultural job [OR 7.001, 95% CI 1.604- 30.648]. Distinct patterns of HCC risk factors exist among cirrhotic and noncirrhotic patients, with a common ground. The risk factor of HCC in cirrhotic patients was underground water use while chronic HBV infection and manual agricultural job were risk factors in noncirrhotic patients. For both cirrhotic and noncirrhotic patients, tobacco smoking and metabolic syndrome were common risk factors of HCC
Subject(s)
Humans , Male , Female , Risk Factors , Liver Cirrhosis , Smoking , Metabolic Syndrome , GroundwaterABSTRACT
This study included 302 patients with liver cirrhosis and esophageal varices who were classified into five groups; two groups of primary prophylaxis and three groups of secondary prophylaxis. The first group was under propranolol therapy [88 patients] and the second group was the control group [62 patients] with a mean age of 49 years and the mean follow up period was 2.97 +/- 1.88 years for the former and 2.35 +/- 1.1 years for the latter. It was concluded that propranolol is an effective treatment in primary prophylaxis as it decreases the rate of bleeding while increases the need for and the amount of blood transfusion. Also, this study supported the long-term use of propranolol plus endoscopic sclerotherapy for secondary prevention of bleeding esophageal varices