[Isolated Crohn's disease of the stomach presented as plastic linitis. One case report]

Introduction: Crohn's disease of the stomach is rare. There is nearly always concomitant disease in the small bowel or colon. Gastric involvement occurs rarely as an isolated entity. Upper endoscopy is sensitive for detecting subtle disease but more extended lesions can mimic neoplasms such us linitis

Exegese: A 74-year old female was admitted to hospital with abdominal pain, vomiting and weight loss. Upper endoscopy and radiology aspects was suspicious of gastric linitis. Multiple endoscopic biopsies of the stomach showed one granuloma, chronic inflammation and Helicobacter Pylori. Because of the importance of obstructive syndrome, the patient underwent surgery. The resected stomach concluded to a Crohn's disease

Conclusion: Through this observation, we review clinical characteristics, diagnostic difficulties and treatment options of Crohn's disease of the stomach

Traitement des pochites par les probiotiques

the aim of the study was to review the principal effects of probiotics on pouchitis and identify their mechanisms of action. the study was based on a review of all relevant studies published in the literature on the effects of probiotics in pouchitis and their possible mechanisms of action. pouchitis is the major long-term complication after ileal pouch anal anstomosis for ulcerative colitis. The cause is still unknown but is likely to be multifactorial. An imbalance in the usual fecal flora was recently suggested. Most patients with symptoms of pouchitis respond promptly to antibiotics. However, 5-10% of them develop rapidly relapsing symptoms that require protacted therapy. Porbiotics are living microorganisms that ingested in adequate amounts exert beneficial effects. Promising results have been obtained with probiotics mainly in maintenance of remission of chronic pouchitis and also as induction of remission. These results suggest that restoring the microbial imbalance may offer an effective therapeutic alternative to patients with pouchitis

Role de la flore intestinale dans les maladies inflammatoires chroniques de l'intestin et place des probiotiques dans leur prise en charge

The pathogenic role of certain microorganisms of intestinal flora has been demonstrated in experimental colitis in animals and strongly suspected in inflammatory bowel disease in human, especially in Crohn's disease and pouchitis. Probiotics are living non pathogenic microorganisms that, upon oral ingestion exert benefits on human health by modulating enteric flora or by stimulation of local immune system. The aim of this article is to remind the role of intestinal flora in inflammatory bowel disease, the mechanism of inflammation induced by this flora and to review through the literature, the different clinical studies performed with probiotics in human

Pathogenie de l'hepatite auto-immune

the aim of the study was to review the pathogenic mechanisms of auto-immune hepatitis. the study was based on a review of all relevant articles from literature on the mechanisms of auto-immunity in auto-immune hepatitis. the precise mechanisms through which liver damage occurs are not fully understood. Autoimmune hepatitis seems to be a consequence of auto-antigen exposure, genetic predisposition and defective immuregulatory mechanisms. Auto-antigen is presented by class II molecules of the major histocompatibility complex. Cytokines and non specific auto-immune promoters modulate immune reactivity. Cellmediated and antibody-dependent forms of cytotoxicity are probably interactive pathogenic mechanisms. disturbance in the tight balance between auto aggression and self-tolerance, affected by several internal and external factors are likely in auto-immune hepatitis

Inhibiteurus selectifs de la cyclo-oxygenase-2 et tube digestif

The use of non steroidal anti-inflammatory drugs [NSAIDS] is tempered by the development of side effects primarily in the gastro-intestinal tract. These effects result mainly from inhibition of the enzyme cyclo-oxygenase [COX]-1. Two NSAIDS [celecoxib and rofecoxib] COX-2 specific inhibitors had considerably lower ulcerogenic rates and lower serious gastro intestinal side effects when compared with other NSAIDs used in rhumatoid arthritis and osteoarthritis. However, the exact place of COX-2 specific inhibitors remain to be determined as compared with the association of other NSAIDs and proton pump inhibitors in the elderly. The efficacy of COX-2 specific inhibitors in digestive tumors is still unclear

[Liver disorders specific to pregnancy]

The liver diseases of pregnancy are specific liver disorders during the pregnancy. The principal hepatic anomaly during hyperemesis gravidarum is a reversisble augmentation of liver enzymes under reanimation. lntrahepatic cholestasis of pregnancy occur during the last 2 trimesters of pregnancy, manifested usually by pruritis preceeding a jaundice. The liver enzymes and the serum biliary acids are augmented. The acute fatty liver of pregnancy occur during the last trimester of pregnancy leading to early interruption of pregnancy which would help to diminish the elevated level of maternal and fetal mortality. The HELLP syndrome usually observed during the toxemia of pregnancy, associate an hemolysis elevation of liver enzymes and low platelets

Gastric malt lymphoma. A clinico-pathological study of 65 cases. Relationship to Helicobacter pylori

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