ABSTRACT
Background: The surveillance of cirrhotic patients for early detection of hepatocellular carcinoma is recommended but its efficacy is now discussed
The aim of our study was to present the results of a screening program in 110 patients
Methods: it is a retrospective study that included 110 patients with cirrhosis in a screening program of hepatocellular carcinoma, based on the realization of abdominal ultrasound exam and the determination of alpha-fetoprotein amount every 6 months in 95 patients and every 3 months in 15 patients
Results: the mean duration of the surveillance was 36 months. A hepatocellular carcinoma was diagnosed in 13 patients. Curative treatment was done in only 3 cases and consisted in a hepatic resection in 1 patient and an alcoolisation in 2 cases. Ten patients had new treatment: for 8 patients the discussed was very aggressive and 2 patients had a server hepotic failure
The cost of this study was 37.500 Tunisian dinars
Conclusions: systematic screening for hepatocellular carcinoma offer a limited cost effectiveness ratio
Subject(s)
Female , Humans , Male , Carcinoma, Hepatocellular/therapy , Retrospective Studies , Liver Cirrhosis/complications , Mass Screening/economicsABSTRACT
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
Subject(s)
Humans , Male , Female , Biliary Tract Diseases/therapy , Prospective Studies , Portal System/pathology , Bile Ducts/pathology , Portal VeinABSTRACT
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