[Intestinal intussusceptions in adults]. / L'invagination intestinale de l'adulte: à propos de 20 cas.

BACKGROUND: Intestinal intussusception occur when a portion of the gastrointestinal tract invaginates into the part of the tract that precedes into the peristaltic direction. AIMS: To determine clinical presentation, diagnostic methods and outcome of the intestinal intussusception and to compare our results to previous data. METHODS: A retrospective study of 20 patients with mean age of 40 years admitted between 1982 and 1999 and underwent surgery for intestinal intussusceptions. RESULTS: Our patients were 10 males and 10 females. The clinical findings were essentially abdominal pain (90%). Preoperative diagnosis of intestinal intussusceptions was established in 30% of cases. Intussusceptions were ileo-ileal (n=10), ileo-colic (n=7) and colo-colic (n=3). 12 patients had tumors. For all intussusceptions involving the colon, all patients underwent resection while intussusceptions located on the small bowel were treated by reduction then resection or simple reduction then fixation. The mortality rate was 5%. CONCLUSION: Intestinal intussusception in adults is uncommon in comparison with children. Correct diagnosis is often established during surgery. Resection is recommended because of the frequent malignancy.

[Autoimmune hepatitis type 1 triggered by cytomegalovirus infection. One rare case report]. / Infection à cytomégalovirus révélatrice d'une hépatite auto immune de type 1.

BACKGROUND: Autoimmune hepatitis is chronic and uncommon disease. The pathogenesis is a complex process. Several triggers for autoimmune hepatitis particularly viral herpesviridae infection, which may induce the development of autoimmunity in predisposed individuals. AIM: Report a new case. CASE REPORT: We report a case of 17-year- woman presented with autoimmune triggered by cytomegalovirus infection. Cytomegalovirus induced autoimmune hepatitis has not been reported previously. Evolution was favourable under antiviral treatment, corticosteroid and azathioprine.

Transverse myelitis associated with chronic viral hepatitis C.

BACKGROUND: HCV infection could cause several extra hepatic diseases including mixed cryoglobulinemia. Peripheral neuropathy is the most common complication of mixed cryoglobulinemia. In addition to cryoglobulinemia's neuropathy, transverse myelitis had been related to HCV infection. AIM: But causality of this association is not clearly established. CASE REPORT: A 55-year-old man presented with motor deficiency in lower extremities and urinary retention. Neurological exams showed a spastic paraparesis and proprioceptive ataxia. Spinal MRI revealed a contrast enhancing signal abnormality within the spinal cord extending from Levels C3 to C5. Serology hepatitis C and viremia were positive. Clinical diagnosis of acute demyelinating sensorimotor polyneuropathy associated to chronic hepatitis C was etablished. CONCLUSION: Screening of HCV infection must be done in patients with transverse myelitis and no clear aetiology.

[Association Budd Chiari syndrome, antiphospholipid syndrome and Grave's disease]. / Association syndrome de Budd Chiari, syndrome des antiphospholipides et maladie de Basedow.

BACKGROUND: Antiphospholipid syndrome is revealed by Budd Chiari syndrome in 5% of the cases. Antiphospholipid syndrome is characterized by venous or arterial thrombosis, foetal loss and positivity of antiphospholipid antibodies, namely lupus anticoagulant, anticardiolipin antibodies and anti-beta2-glycoprotein I. Anticardiolipin antibodies was reported in auto-immune thyroid disorders, particularly in Grave's disease. Antiphospholipid syndrome associated to Grave's disease was reported in only three cases. AIM: To describe a case report of association of Grave's disease and antiphospholipid syndrome. OBSERVATION: We report the first case of Grave's disease associated with antiphospholipid syndrome, revealed by Budd Chiari syndrome. CONCLUSION: Our observation is particular by the fact that it is about a patient presenting a Grave's disease associated with antiphospholipid syndrome revealed by Budd Chiari syndrome. This triple association has never been reported in literature. Although association between antiphospholipid syndrome and Grave's disease was previously described, further studies evaluating the coexistence of these two affections in the same patient would be useful.

Inflammatory pseudotumor of the liver associated with Crohn's disease.

Inflammatory liver pseudotumor is a rare entity. Associations with several inflammatory conditions were reported but association with inflammatory bowel disease is unusual. We report the case of liver inflammatory pseudotumor occurring in the course of Crohn's disease in a 23-year-old woman and treated conservatively.

[Auto-immune serological disorders in chronic viral C hepatitis: prevalence and clinical significance]. / Anomalies serologiques auto-immunes au cours de l'hepatite chronique virale C: prevalence et signification clinique.

BACKGROUND: Hepatitis C viral (HCV) infection has been shown to lead to auto-immune phenomena. AIMS: We review the prevalence of serological auto-immune disorders associated to HCV infection and to clarify their clinical significance. METHODS: Literature review. RESULTS: The serological immune response to HCV infection may include the development of cryoglobulinemia, rheumatoid factor, anticardiolipin, antinuclear, anti-liver-kidney-microsome 1 and anti-smooth muscle antibodies. Serological auto-immune manifestations were explained by the lymphotropism of HCV and the polyclonal activation of B cells. Interferon-based treatment of HCV infection may precipitate or exacerbate the associated auto-immune disease. CONCLUSION: In patients with serological auto-immune disorders associated with HCV infection, a very careful analysis of clinical and biological features is needed. Application of classification criteria of systemic auto-immune diseases and testing more specific antibodies can resolve this point.