Annales de gastroenterologie et d'hepatologie最新文献

Two new cases of Menetrier's disease with gastric adenocarcinoma in two men aged 62 and 81 years, respectively, are reported. In both cases, the diagnosis was established by histologic examination of the operative specimen. Emphasis is placed on diagnostic difficulties and on the risk of malignant transformation of Menetrier's disease, which should be viewed as a precancerous gastric lesion.

Senegal is a country with a high incidence of hepatocellular carcinoma (HCC). The role of the hepatitis B virus (HBV) in the genesis of HCC is well established. To evaluate the role of the hepatitis C virus (HCV) in the occurrence of HCC in Senegal, second-generation serologic tests were used to compare the prevalence of anti-HCV antibody in subjects with HCC and in controls without liver disease. A polymerase chain reaction assay was used to look for HCV RNA in sera from patients with HCC and anti-HCV antibody. HBV markers were assayed in all study subjects. Prevalences of anti-HCV antibody were 10.9% (7/64) in the HCC group and 5% (3/58) in the control group (NS). In the HCC group, anti-HCV antibody was found in 2.4% (1/42) of subjects positive for the hepatitis B antigen (HBsAg) versus 27.2% (6/22) of subjects negative for the HBsAg (p < 0.01). HCV RNA was detected in five of six anti-HCV-positive HCC patients. Prevalence of the HBsAg was 65.6% (42/64) in the HCC group versus 17.2% (10/58) in the control group (p < 10-8). Anti-HBV antibody was detected in 48.3% (28/58) of controls versus 6.3% (4/64) of HCC patients (p < 10-8). These data do not support a close epidemiologic association between the HCV and HCC in Senegal, where the HBV remains the main viral cause of HCC.

Concomitant occurrence of Takayasu disease and Crohn's disease is exceedingly rare and raises questions about shared causes or etiopathogenic mechanisms. A 19-year-old man developed pulmonary tuberculosis followed by Takayasu disease immediately after a total colectomy procedure for Crohn's disease. The various facets of this combination are analyzed. In the case reported herein, there was no evidence in support of a causal relationship between the two diseases or shared etiopathogenic mechanisms.

Twenty-two cases of abscess of the liver are reported. Eighteen were due to pyogenic organisms and four to amebas. The diagnosis was established based on clinical and laboratory evaluations and, above all, on ultrasonography with aspiration of the lesion. The causative organism was recovered from the aspirate in 33.3% of cases. Seventeen patients were treated by percutaneous aspiration. Two patients required insertion of a drain because of a biliary fistula. The success rate of percutaneous aspiration with or without drainage was 88.2% in our series. The two patients who had surgery had loculated abscesses with thick pus. In conclusion, the diagnosis and treatment of hepatic abscesses have benefited from advances in imaging techniques; in particular, aspiration or drainage can be performed simply under ultrasonographic guidance.

A case of anomalous pancreaticobiliary union with ectopic drainage of the common bile duct into the third part of the duodenum was diagnosed in an 86-year-old woman upon evaluation of acute pancreatitis. The role of anomalous pancreaticobiliary unions in the genesis of acute pancreatitis is discussed.

The digestive linitis plastica is a special form of the little differentiate adenocarcinoma that can reach all the segments of the digestive tube, if the gastric localization is the most frequent, the double gastric and rectal localization is rare (7%) either is simultaneous or successive. The pathologic examination arrives only at the diagnostic of the digestive linitis without biasing against its primitive and secondary character. We report a case of this association in order to focus the importance of search and difficulty of the histologic diagnosis. Mis H.N., aged of 69 years old was hospitalized because she was reached of subocclusive syndrome, the rectal touch, found a circumferential marrowing with indurated basis at 7 cm of the anal margin, the gastroduodenal transit and the high digestive fibroscopy were evokating of a total plastic linitis. The gastric biopsy confirmed the diagnosis by the presence of cells ou kitten ring. The patients died during the hospitalization, the pathologic study of the postmortem rectal swab showed the existence of a rectal linitis. The discovery of a gastric linitis makes necessary a systematic, endoscopic and radiologic complete physical examination in order to discover other digestive localizations, this darkens singularly the prognosis and complicates the therapeutic attitude.

Ten patients (5 male, 5 female, mean age: 29.4 years) with tuberous sclerosis were investigated for gastrointestinal polyps. Three had adenomatous colonic polyps, one had a single duodenal hamartomatous polyp and the fifth a hyperplastic gastric polyp. This high prevalence (50%) should put the gastro-intestinal investigation as a useful test in the diagnosis of tuberous sclerosis, particularly in the incomplete varieties of disease. Conversely, tuberous sclerosis should be considered in the differential diagnosis of digestive polyposis.

An oxidative stress occurs in the liver of rats following various conditions of ethanol administration. The ethanol-inducible cytochrome P450 2E1 plays a key role in its generation, favoured itself by an increase in the "redox-active" fraction of intracellular non-heme iron. Administration of ethanol elicits the generation of the 1-hydroxyethyl radical, which has been identified in vivo. Its reactivity contributes to alcohol-induced immunological disturbances. Liver inflammatory and fibrotic disorders can be reproduced in rats by long-term ethanol administration associated with a high fat diet. The severity of these disorders is correlated to the intensity of the oxidative stress. Some conditions of ethanol administration to rats also elicit an oxidative stress in the myocardium and central nervous system. Through its inhibitory effect on glutamine synthetase activity and resulting excitotoxicity it may contribute to neuronal death and possibly to dependence on alcohol. Disorders related to an oxidative stress were also reported in the serum and erythrocytes as well as in liver biopsies from alcoholic individuals. Their detection may be useful to follow the evolution of alcoholic liver diseases. Supplementation with antioxidants such as vitamin E may be considered in the prevention of severe cellular disorders in individuals consuming large amounts of alcoholic beverages. An increase in free radical production is likely playing a role in the induction of severe cellular damage linked to repeated withdrawals occurring as a result of heavy and sporadic ethanol intake.