Résumé
Background and study aim: Gastrointestinal stromal tumours [GISTs] are the most common mesenchymal tumours of the gastrointestinal tract, originating from Cajal cells in different sites of the digestive tract. The aim of the study is to report on epidemiological, clinical, histological, and therapeutic characteristics of GISTs
Patients and methods: A retrospective descriptive study of 29 cases of GIST in gastroenterology and general surgery departments of Mohamed Tahar Maamouri Hospital [Nabeul, Tunisia] was conducted from January 2005 to March 2012
Results: Among the 29 patients, there were 18 males [62%] and 11 females [38%] with a median age of 63 years [range, 30-96 years]. The main symptoms were abdominal pain [40%] and weight loss [28%]. The tumour was revealed by a complication in 5 cases [17%]. Six patients [20.7%] had metastatic lesions. The most common sites were the stomach [41.4%] and the small intestine [17.3%]. The median tumour size was 9.5 cm [range, 1-30 cm]. Spindle cell tumours were the main histological type [62%]. KIT was positive in the majority of cases [75%]. Twenty-one patients with primary disease [72%] underwent a surgical resection. Imatinib was prescribed in 7 patients [24%]. Sunitinib malate was indicated in 3 patients who had tumour progression under imatinib. Median survival was 17 months [range, 1-69 months]. Ten patients died
Conclusion: The management of GISTs has considerably evolved during the last years. Surgical resection, which remains the mainstay of treatment, was indicated in the majority of patients. Imatinib treatment has not improved overall survival in metastatic and/or inoperable cases
Résumé
Background and study aims: Gastric outlet obstruction [GOO] is a rare complication of peptic ulcer disease [PUD]. The endoscopic balloon dilatation [EBD] associated with medical treatment of Helicobacter pylori is a successful method in the management of pyloric stenosis. The aim of this study was to describe epidemiological, clinical, and endoscopic characteristics of GOO related to PUD and to evaluate the effectiveness, safety, and outcome of EBD
Patients and methods: In a retrospective study of patients seen between 1999 and 2009 with symptoms of GOO secondary to PUD, pyloro-bulbar stenosis was confirmed by endoscopic examination. Balloon dilatation was performed when obstruction persisted after treatment with double-dose proton-pump inhibitor [PPI] intravenously for 7-10 days. The H. pylori status was assessed with histology, and eradication therapy was prescribed for infection
Results: A total of 45 consecutive patients [38 males, 7 females median age, 51.9 years; range, 20-58 years] with symptoms of GOO secondary to PUD underwent EBD. Median follow-up time of the 45 patients was 32 months [range, 4-126 months]. The immediate success rate of the procedure was 95.5%. Clinical remission was noted in 84.4% of the patients. Remission without relapse was observed in 55.8%, 30 months after the dilatation. Pyloric stenosis relapsed in 15 patients [39.5%] after a median period of 22.9 months. The dilatation was complicated in three patients [6.7%, two perforations and one bleeding]. A total of 13 patients [29%] underwent surgery. H. pylori was found to be positive in 97.7% of the patients, and was eradicated in 78.4% of them. Smoking and failure of H. pylori eradication were associated with the relapse of the stenosis
Conclusion: EBD is a simple, effective, and safe therapy for the GOO related to PUD, producing short- and long-term remission
Sujets)
Humains , Adulte , Adulte d'âge moyen , Mâle , Femelle , Dilatation , Dilatation gastrique , Ulcère peptique , Endoscopie , Helicobacter pylori , Infections à Helicobacter , Études rétrospectivesRésumé
Patients with inflammatory bowel disease [IBD] are at increased risk of thromboembolic complications [TEC], which represent an important cause of morbidity and mortality. To assess the prevalence and risk factors of TEC in patients with IBD. We conducted a retrospective study including all the IBD patients in the gastroenterological department of Charles Nicolle hospital between 2000 and 2010. Only thromboembolic events that had been diagnosed by an imaging procedure were counted. A total of 266 patients with IBD were consecutively included. TE events occurred in nine patients [3.4%]; six men and three women. Their mean age was 31years [15-64 years]. Five patients had Crohn's disease and four had ulcerative colitis. The types of TEC were deep venous thrombosis of the leg in five cases with pulmonary embolism in one of them, cerebral venous thrombosis in two cases, portal thrombosis in one case and jugular vein thrombosis in one case. Active disease was present in all cases at the time TEC occurred. In our study, the prevalence of TEC is 3.4% in patients with IBD. Deep venous thromboses of the leg are the most common TEC and all our cases occurs during the active phase of IBD