[Endoscopic ultrasonography versus helical CT in diagnosis and staging of pancreatic cancer]

Compare the performances of EUS to helical CT in the diagnosis and staging of pancreatic adenocarcinoma. Forty two consecutive patients [mean age 63 years; 25 men, 17 women] who had surgical exploration and histologically proved pancreatic cancer were retrospectively included. All our patients underwent with endoscopic ultrasonography [EUS] and helical computed tomography [helical CT]. Data analysis compared helical CT, EUS with the surgical data with or without histological study in diagnosis, staging and resectability of pancreatic cancer. Surgical findings were used as gold standard. For positive diagnosis EUS was more sensitive 100% [CI:93-100] than helical CT 88% [CI:77-95]. But helical CT was more specific 89% [CI:64-98] than EUS 83% [CI:58-96] for small tumors whose diameter is below 2,5 cm in which EUS was more sensitive in their detection [100% versus 83%]. In evaluating venous involvement EUS was more sensitive than helical CT [96% versus 50%; p<0.05], while CT was more specific [81% versus 75%; p<0.05]. Regarding lymph nodes invasion, the two imaging technique had the same sensibility [56%] with better specificity for helical CT [83% versus 75%; p<0.05]. The accuracy of EUS in identifying the T and N stages were 80% and 67% respectively, while helical CT have an accuracy of 50% and 71% respectively. EUS and helical CT correctly identified all resectable tumors while EUS was more accurate than helical CT in detecting non resectable tumors 94% versus 69%.EUS remains superior to helical CT in positive diagnosis of pancreatic adenocarcinoma especially for small tumors and also for the diagnosis of venous invasion and in identifying non resectable tumors. The two techniques have the same accuracy in the detection of lymph node involvement

[Prevalence of malnutrition in gastroenterology hospitalized patients: a 70 patients prospective study]

Malnutrition is a common problem in gastroenterology hospitalized patients. Its frequency varies considerably with the studied population and nutritional screening tools. The purpose of this study was to assess the prevalence of malnutrition in gastroenterology hospitalized patients. A prospective study was carried between January 2005 and March 2005 including 70 patients. The nutritional state of the patients was assessed according to the subjective global assessment scale [SGA]. anthropometric measurements and serum albumin level. Moderately and severely malnutrition was found for 54 patients [77 percent]. Statistical analysis found positive correlation between body mass index [BMI] and SGA C [p=0 .002] and between albumin level and SCA [p<0.005]. The median nutritional risk index [NRI] was 89.5 +/- 13 with significantly positive correlation with the other parameters [BMI, Albumin and SGA] respectively p=0.03, p=0.003 and p=0.004. Malnutrition is common in gastroenterology patients. The assessment of patient's nutritional state according to the subjective global assessment had a positive correlation with the others nutritional screening tools

[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