[Incidence of duodenal ulcer in the city of Reims 1988]. / Incidence de l'ulcère duodénal dans la ville de Reims en 1988.

No epidemiological data on the incidence of duodenal ulcer are available for a well-defined population in France. We therefore conducted a prospective study in the urban population of Reims. All radiologists, gastroenterologists and surgeons of this town were asked to report all new cases of duodenal ulcer seen during one year. During 1988, 114 new cases were identified. Age standardized incidence using world population standards were 83.6/100,000 for males and 29.5/100,000 for females. The male/female ratio was 2.8. Mean age at the time of diagnosis was 51.9 years, higher for females (63.4 years) than for males (48.0 years). Nearly one third (32.5%) of duodenal ulcers presented with complications (haemorrhage or perforation) at the time of initial diagnosis.

Lymphoid follicular proctitis. A condition different from ulcerative proctitis?

A heterogeneous group is formed by patients presenting with clinical features suggestive of inflammatory bowel disease limited to the rectum and whose rectal biopsies show lymphoid follicular hyperplasia of the mucosa. All these cases are traditionally considered as one variant of chronic ulcerative colitis, so-called ulcerative proctitis. Twenty such cases were critically assessed on clinical, endoscopic, and histologic grounds, as well as on response to treatment and follow-up data. While 11 patients showed clinicopathologic features consistent with typical chronic ulcerative colitis, the other nine patients appeared to form a different group, for which the term "lymphoid follicular proctitis" seemed justified. Lymphoid follicular proctitis was, overall, characterized by rectal bleeding, a congested and granular mucosa without ulceration, abnormal and coalescing hyperplastic lymphoid follicles without acute inflammation, and failure to respond to local steroid therapy. The nature of lymphoid follicular proctitis is uncertain at present but seems unrelated to chronic ulcerative colitis.

Incomplete sulphomucin-secreting intestinal metaplasia for gastric cancer. Preliminary data from a prospective study from three centres.

A joint prospective long term study of gastric biopsies has been undertaken to survey intestinal metaplasia Types I, II, and III in terms of their incidence, distribution and value in the selection of high risk cancer patients. This study is based on protocols agreed between three centres for endoscopy, histological interpretation, and mucin histochemistry. The results on the first 1350 gastric biopsies examined during 1981-1982 are presented. Intestinal metaplasia was found in 267 biopsies (20%), being common in association with carcinoma (71%), less so in benign conditions such as gastric ulcer (39%), and chronic gastritis (24%), but rare in 'normal' (3%). Type I intestinal metaplasia was predominant (73%) in all the biopsies with intestinal metaplasia and was most common in benign conditions, 70% in gastric ulcer and 76% in chronic gastritis. Type III intestinal metaplasia (incomplete sulphomucin-secreting intestinal metaplasia) was recorded in only 9.8% of all the biopsies with intestinal metaplasia and had a higher incidence in carcinoma (35%), than in benign conditions (7%) (p less than 0.0001). These results suggest that intestinal metaplasia types may have different malignant potential and their identification may be useful in screening patients for early detection of cancer.

[Solitary ulcer of the rectum (author's transl)]. / L'ulcère solitaire du rectum.

Solitary ulcer of the rectum is no longer considered as an idiopathic or autonomous disease. It is probably due to mucosal microtraumas, the most frequent being that resulting from anterior or complete rectal prolapse. Characteristic histopathological features can easily be recognized in biopsies taken from the edges or around the ulcers. This concept leads to a policy of consistent therapeutic measures: re-education of bowel habit and as a last resort surgery, either abdominal proctopexy or postanal pelvic floor repair.