[Biliary abnormalities associated to portal cavernoma: about 17 cases]

Portal biliopathy is a newly introduced term, describing the changes observed in the biliary ducts secondary to extrinsic compression by the portal cavernoma. It's a rare condition that is usually not diagnosed. To explore the principles of diagnosis and treatment of portal biliopathy. Seventeen patients with extrahepatic portal vein obstruction were reviewed prospectively. Symptomatic biliary obstruction was found in 82%. Endoscopic retrograde cholangiography revealed abnormality of the bile duct wall in all cases, with stricture in 11 patients. Endoscopic treatment was necessary in 10 patients. Whether portosystemic shunting was done only in 2 cases. Portal biliopathy is frequent and must be diagnosed early

[Prospective study of 420 biopsies realised in patients with duodenal ulcer with positive Helcobacter pylori]

It's a prospective study leaded between September 1997 and July 1999 [23 months] in 75 patients with duodenal ulcer and positif for Helicobacter pylori. All patients had a first endoscopy with antral, fundic and duodenal biopsies, followed one months later by a second control fibroscopy with biopsies of the same sites. A total of 420 biopsies was realized. Chronic gastritis was evaluated according to sydney system. Patients was divided by randomization in 4 groups. Every group was received a different therapeutic association. The results was conform to liberation concerning activity 80%, intestinal metaplasia 12%, inflammation 100%. Atrophy was observed in 56% of cases, this percentage is variable in literature; chronic gastritis was predominant in antre relatively to fundus [p< 0.005]. After treatment, a significative fall of Helicobacter pylori and activity and atrophy was established, contrariety to intestinal metaplasia and chronic inflammation witch are persisted. The prevalence of follicular gastritis was 57%. The better rate of ulcer cicatrisation and Helicobacter pylori eradication was respectively of 79% and 66% in group 1 treated by omeprazol, amoxicillin, metronidazol by comparison with the others 3 groups [p< 0.005]

Traitement endoscopique de la lithiase residuelle a propos de 661 cas

Endoscopic sphincterotomy is a well-established procedure for treating choledocolithiasis and particularly residual lithiasis. The aim of this study is to expose our experience with this method and to evaluate its safety and efficacy. It is a retrospectively collected series of 661 patients with residual choledocolithiasis. Endoscopic retrograde cholangio-pancreatographies were performed in 651 patients [98.5%]. Standard sphincterotomy was realized in 633 patients [95%] and a pre-cut technique was done in 15 [2%]. Bile duct clearance was achieved in 583 cases [91%]. Overall, the complication rate of sphincterotomy was about 8.4%. Endoscopic sphincterotomy is a safe and effective procedure for patients with residual choledocolithiasis

[Gastrointestinal angiodysplasia: about 54 cases]

Angiodysplasia is an arteriovenous malformation which can reach the entire gastrointestinal tract and especially the colon. Its management is often difficult. The aim of this study was to assess the clinical, topographic and therapeutic characteristics of angiodysplasia. It is a retrospective study including 54 cases of GI angiodysplasia collected over 13 years. The mean age was 62 years: 66% were males. Angiodysplastic lesions were predominantly located in the colon [85%]. Nine patients required an endoscopic treatment. Electrocoagulation was used in 8 cases and a sclerotherapy in 1 case Surgical resection was necessary in 2 patients which died of the after-effects of surgery.: angiodysplasia is a common etiology of chronic lower 61 bleeding particularly in the elderly

[Gastrointhstinal stromal tumors. a study of 5 cases]

G1 stromal tumors are mesenchymatal tumors arising primarily from the digestive tract or from the omentum. Despite their rarity [less than I% of digestive tumors]. These tumors have become of current interest since the discovery of a treatment for metastatic and locally advanced tumors, the imatinib [Glivecr]. In this study we report 5 cases of stromal tumors. Patients were 42 years old an average. Abdominal mass was the revealing signal in 80% of cases, localisation was obtained by endoscopy and ultrasonography in 60% cases. Total resection of the tumor was performed in all patients. Immuno-histochemical examination confirmed the diagnosis of stromal tumors. Based on these cases and on a review of literature, we insist on the diagnostic difficulties of this rare pathology, while trying to determine the histological prognostic parameters and the latest therapeutic methods