[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

[Epidemiologic profile of gastric carcinoma: study of 140 cases]

The authors make a retrospective study of a series of 140 patients aged 59 years in average, followed up from 1995 to 2002 for adenocarcinoma of the stomach. Surgical resection was performed in 79 percent of the patients with total gastrectomy in 15.4%, partial gastrectomy in 50.6%. Resection was considered as curative in 66%. Lymph node metastases were present in 42, 9 percent of the patients. Margins of resection were involved in 24, 5% of the specimens. The mean survival rate was 26.5 months, 13 months and 5 months after curative resection, palliative resection and without resection

[Importance of vaccination chronic hepatitis B]

Weak therapeutic responses and weak immune cytotoxic CD8 and CD4 response in chronic hepatitis B emphasize the necessity to find new therapeutic strategies especially as specific immunotherapy. Vaccination, whose principle was to widen immune repertoire, was used as a curative treatment of chronic hepatitis B. It would be the therapeutic procedure with the lowest cost and the potentially greatest benefit. Our purpose was to enhance the interest of therapeutic vaccination in chronic hepatitis B in order to debate later its usefulness in developing countries

Identification des patients a haut risque de rechute de la maladie de Crohn

The aim of this study is to determine the factors associated with high risk of recurrence of Crohn disease. Patients and methods: During 12 years period from January 1987 till December 1999, 98 patients treated for crohn's disease were included in this study. The risk of recurrence was studied using the Kaplan -Meier method. The possible predictive factors of recurrence were studied using the LOG-RANK test. During the follow-up period, 50 [66%] patients developed a recurrence of Crohn's disease. The factors associated with a high risk of recurrence of the diseases were female [p=0,03], long delay before the diagnosis of the disease [p=0,03] and the presence of extra-intestinal lesions [p=0,05]. Concerning other factors such as the age, smoking, inflammatory syndrome and ano-perineal lesions, the study showed no relationship between these factors and the recurrence of the disease. This study showed that the group of patients treated for crohn's disease and who have predictive factors of recurrence should have prophylactic medical treatment to prevent recurrence of the disease

[Biliary attacks of surgery of the liver hydatid cyst]

The goal of this work was to describe secondary biliary attacks due to liver hydatid cyst surgery and see their different physiopathological mechanisms again. We report three cases of secondary sclerosing cholangitis. There were three women aged 20, 40 and 60 years. respectively. Icterus was the primary sign in the three cases. The three patients were operated on for liver hydatid cyst with a peroperative injection of the scolicide product. The diagnosis of secondary sclerosing cholangitis was based on the thin aspect of the biliary ducts. The generally benign liver hydatid cyst disease may be the cause of a serious and final biliary attack

Utilisation de l'octreotide dans le traitement des hemorragies digestives aigues par rupture de varices oesophagiennes

Aims To asses the value of octreotide in the control of acute bleeding esophageal varices in a retrospective study Methodology: Fourty two patients admitted for esophageal voriceal bleeding confirmed at endoscopy were recruired.An initial 50 micrograms bolus of octreotide followed by a two day continuous infusion of 25 micrograms/h were evaluated for the control of bleeding. Twenty nine patients were endoscopic stigmata of recent bleeding and thirteen were active bleeding at emergency endoscopy. Octreotide was found to be effective regarding hemostasis at 48 hours and on day 7 after the index bleeding episode. 30 day mortality was 1 1,9%. Echec of octreotide was significativement associated with severity of cirrhosis [p<0, 03]. Conclusion These results suggest that octreotide is effective in the treatment of esophageal variceal bleeding and it is a valuable adjuvant treatment in association with endoscopic menagement

steatohepatite non alcoolique: Une pathologie emergeante et potentiellement grave

Nonalcoholic steatohepatitis is an acquired liver disease, usually metabolic coracterised by histologic lesions with steatosis, intralobular necrosis and inflammatory infiltrates. Liver biopsy finding are identical to those seen in alcoholic hepatitis. Nonalcoholic steatohepatitis is increasingly, reported in industrial countries because of an increase of the prevalence of obesity and diabetes wich are the most commonly risk factors of this disease. The diagnosis of nonalcoholic steatohepatilis is based of a confrontation between clinical and anatomic data and an exclusion of an excessive intake of alcohol and other hepatic disease. Liver biopsy has a prognosis and histologic benefit especially when there is risk factors of fibrosis.This disease is potentialy severe with a potential risk for progression to cirrhosis. Progress in pathogenesis is noted but no definite therapy exist.The aim of this review is to indicate current knowledge for the gravity of nonalcoholic steatohepatitis and its consequence and to understand the pathogenesis to prevent cirrhosis