ABSTRACT
BACKGROUND: Primary sclerosing cholangitis (PSC) is a chronic cholestatic disease strongly associated, in the western series, to inflammatory bowel disease (IBD) and particularly to chronic ulcerative colitis. North African data are rare. aim : To study the epidemiological, clinicobiological and morphological profile of PSC in Tunisia. methods: A retrospective multicenter study extended over a period of 14 years (1995-2009), including all patients suffering from PSC, hospitalized in the four participants departments. We collected epidemiological, clinico-biological, histopathologic and morphological data for each patient. results: We brought together 33 patients (22 men and 11 women), middle aged 44 years. The disease was symptomatic in 73% of cases. Laboratory tests showed cholestasis (100%) associated with hyperbilirubinemia (72%) and a moderate cytolysis (78%). Morphological analysis of bile ducts by cholangioMRI or endoscopic retrograde cholangio-pancreatography objectified diffuse damage of the biliary tract in 61% of cases. Association with IBD was found in 33% of cases (Crohn's Disease: 27%, chronic ulcerative colitis: 6%). An association with autoimmune hepatitis was found in 6% of cases and primary biliary cirrhosis in 3% of cases. Conclusion : PSC is rare in Tunisia and affects men more often than women. The association with IBD is less frequent than in literature. It concerns essentially Crohn's disease. These data require confirmation by prospective multicenter studies.
Subject(s)
Cholangitis, Sclerosing/diagnosis , Cholangitis, Sclerosing/epidemiology , Adolescent , Adult , Aged , Cholangiopancreatography, Endoscopic Retrograde , Cholangitis, Sclerosing/complications , Cholestasis/etiology , Colitis, Ulcerative/epidemiology , Comorbidity , Diagnosis, Differential , Female , Humans , Hyperbilirubinemia/etiology , Incidence , Inflammatory Bowel Diseases/epidemiology , Magnetic Resonance Imaging , Male , Middle Aged , Retrospective Studies , Risk Factors , Sex Distribution , Tunisia/epidemiologySubject(s)
Drainage/instrumentation , Foreign Bodies/diagnosis , Gallstones/etiology , Drainage/adverse effects , Echinococcosis, Hepatic/surgery , Endoscopy, Gastrointestinal , Equipment Failure , Female , Foreign Bodies/etiology , Foreign Bodies/therapy , Gallstones/diagnosis , Gallstones/therapy , HumansABSTRACT
GI stromal tumors are mesenchymatal tumors arising primarily from the digestive tract or from the omentum. Despite their rarity (less than 1% of digestive tumors). These tumors have become of current interest since the discovery of a treatment for metastatic and locally advanced tumors, the imatinib (Glivec). 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.
