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Nadia Maàmouri,
Sabra Guellouz,
Naziha Belkahla,
Fethia Ben Hariz,
Sonia Ketari,
Ines Chelly-Enneifer,
Haykel Bdioui, Hajer Ouerghi,
Soufiane Chouaib,
Zoubeir Ben Safta,
Mohamed Moncef Zitouna,
Nabyl Ben Mami
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ABSTRACT: La lymphangite carcinomateuse (LC) est une entité caractérisée par un envahissement diffus des vaisseaux lymphatiques par
les cellules malignes [1]. Elle est généralement localisée au niveau des poumons. Les localisations extrapulmonaires sont
rares. La LC digestive est exceptionnelle, touchant essentiellement le duodénum, plus rarement l’estomac et l’intestin grêle.
La LC colique n’a jamais été décrite. Nous rapportons deux cas de LC digestive: l’une duodénale, l’autre colique.
Lymphangitis carcinomatosa (LC) is an entity characterised by a diffuse invasion of the lymphatic vessels by malignant cells
[1]. It is generally localised within the lungs. Extrapulmonary localisation is rare. LC of the digestive tract is exceptional,
and essentially affects the duodenum, and more rarely the stomach and the small intestine. LC of the colon has never been
described. We are reporting two cases of LC of the digestive tract: one of the duodenum, the other of the colon.
Acta Endoscopica 04/2012; 39(6):431-433. · 0.09 Impact Factor
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Nadia Maamouri,
Sabra Guellouz,
Faouzi Chebbi,
Fethia Ben Hariz,
Monia Ben Messoud,
Soufiane Chouaib,
Naziha Belkahla, Hajer Ouerghi,
Hatem Chaabouni,
Emna Mnif,
Zoubeir Ben Safta,
Nabyl Ben Mami
La Tunisie médicale 04/2011; 89(4):403-5.
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ABSTRACT: Peritoneal tuberculosis represents 0, 1 to 4% of all forms of tuberculosis.
The aim of our study is to describe clinical, therapeutic characteristics and the outcome of peritoneal tuberculosis.
Retrospective study of all cases of peritoneal tuberculosis diagnosed in gastroenterology B department - Rabta Hospital during a 12 years period (1996 to 2007).
Forty three cases of peritoneal tuberculosis were included: 15 male and 28 female with mean age of 38years (extremes: 16 to 85years). Five patients were cirrhotic. Clinical manifestations were dominated by ascitis (83%). Ascitic fluid were exsudative in 97% of cases and lymphocytic in all cases. The diagnostic was based on coelioscopy with peritoneal biopsy in 26 cases demonstrating caseating granulomatous lesions in 64% of cases. Extra peritoneal tuberculosis was noted in 60, 4% dominated by pleuro-pulmonary localisations. Patients were given antituberculous therapy for a mean duration of 9, 8 months and the outcome was favourable in 93%.
Peritoneal tuberculosis is still a medical problem in Tunisia. It is more common in young female. Diagnosis is based on the results of peritoneal biopsies during celioscopy. The outcome is good in most cases after antituberculous treatment.
La Tunisie médicale 04/2010; 88(4):257-60.
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La Tunisie médicale 05/2008; 86(4):397-8.
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La Tunisie médicale 03/2008; 86(2):189-90.
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La Tunisie médicale 02/2008; 86(1):85-7.
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ABSTRACT: BACKGROUND: Pyogenic liver abscesses are rare and severe. Early diagnosis and treatment lead to a better prognosis. Biliary cause of liver abscesses is the most frequent. Portal origin is secondary to a portal bactremia. Appendicitis was the most cause of portal infection, but actually, diverticulitis is most common. AIM: the aim of this study was to report a new case of pyogenic liver abscesses secondary to phlegmonous appendicitis. CASE REPORT: We report a case of 47 years old man presented with fever and weight loss without abdominal pain. Laboratory investigations show signs of inflammation with high leukocyte and neutrophile rates. The diagnosis of liver abscesses was made on abdominal ultrasound and tomodensitometry witch shows also an inflammatory appendix. The outcome was good after antibiotics associated with percutaneous drainage of abscesses and laparoscopic appendectomy witch found a phlegmonous appendix. One month later, the CT scan showed a markedly decrease of the size of the abscesses.
La Tunisie médicale 08/2007; 85(7):596-9.
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ABSTRACT: INTRODUCTION: Crohn's disease of the stomach is rare. There is nearly always concomitant disease in the small bowel or colon. Gastric involvement occurs rarely as an isolated entity. Upper endoscopy is sensitive for detecting subtle disease but more extended lesions can mimic neoplasms such us linitis. Exégèse: A 74-year old female was admitted to hospital with abdominal pain, vomiting and weight loss. Upper endoscopy and radiology aspects was suspicious of gastric linitis. Multiple endoscopic biopsies of the stomach showed one granuloma, chronic inflammation and Helicobacter Pylori. Because of the importance of obstructive syndrome, the patient underwent surgery. The resected stomach concluded to a Crohn's disease. CONCLUSION: Through this observation, we review clinical characteristics, diagnostic difficulties and treatment options of Crohn's disease of the stomach.
La Tunisie médicale 09/2006; 84(8):513-6.
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ABSTRACT: The pathogenic role of certain microorganism of intestinal flora has been demonstrated in experimental colitis in animals and strongly suspected in inflammatory bowel disease in human, especially in Crohn's disease and pouchitis. Probiotics are living non pathogenic microorganisms that, upon oral ingestion exert benefits on human health by modulating enteric flora or by stimulation of local immune system. The aim of this article is to remind the role of intestinal flora in inflammatory bowel disease, the mechanism of inflammation induced by this flora and to review through the literature, the different clinical studies performed with probiotics in human.
La Tunisie médicale 04/2005; 83(3):132-6.
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ABSTRACT: Actinomycosis is a chronic, granulomatous, suppurative and fistulasing infection related to a gram-positive bacteria (actinomyces israeli). Cervico-facial actinomycosis is the most common localization. The prevalence of abdomino-pelvic actinomycosis is increasing mainly with the increase of the use of intrauterin device. Its clinical presentation is variable and may mimic cancer or tuberculosis. The diagnosis of abdomino-pelvic actinomycosis is hard and most of the cases are detected during surgical exploration. We report two cases of abdomino-pelvic actinomycosis; in the first case, the disease was extended to the caecum and the abdominal wall. The skin biopsies made the diagnosis of actinomycosis, avoiding surgery. In the second case, the diagnosis of actinomycosis is made post operatively because of high suspicion of pelvic cancer. Through these two observations, we review pathogenesis of the disease, its clinical aspects and its diagnostic and therapeutic means.
La Tunisie médicale 09/2004; 82(8):772-6.
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ABSTRACT: Crohn's disease and celiac disease are two chronic digestive diseases. The pathological mechanisms that lead to them are not known. Their association is rare leading to diagnostic and etiopathogenic problems. The aim of this study is to report clinical, endoscopical and histopathological characteristics of this association and to discuss the etiopathogenic links between these two diseases. The association of celiac disease and Crohn's disease is possible although rare. Many etiopathological mechanisms were suggested to explain such an association. In the case of celiac disease, the association with Crohn's disease is suggested by the characteristics of the diarrhea, the anoperineal lesions and will be confirmed by ileocolonoscopy and biopsy. In contrary, the diagnosis of celiac disease associated with Crohn's disease is frequently suggested by the endoscopy of upper gastrointestinal tract systematically practiced and will be confirmed by biopsy and serological celiac disease tests.
La Tunisie médicale 01/2004; 81(12):969-71.
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ABSTRACT: Autoimmune hepatitis and primary biliary cirrhosis are two different liver diseases. The aim of this study is to relate the clinical, serologic and histologic features of patients presenting the overlap syndrome, and to evaluate their response to therapy. This is a retrospective study concerning patients presenting overlap syndrome diagnosed between january 1998 and December 2001. Five patients fulfilled the diagnosis criteria of overlap syndrome. The optimal type of treatment of the overlap syndrome was not known. Treatment with UDCA or immunosuppressor alone are not efficient. Combination of these drugs should be evaluated in further studies.
La Tunisie médicale 08/2003; 81(7):499-504.
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ABSTRACT: The propose of this prospective study was to assess the prevalence of Helicobacter pylori infection in asymptomatic subjects in year 2000. Ninety eight patients not suffering from upper gastrointestinal symptoms were enrolled in this study. The mean age was 39 years. Helicobacter pylori was present in 81 patients (82.7%). Helicobacter pylori infection increase with age. It was maximal between 30 and 50 years. Helicobacter pylori prevalence is still high in Tunisia as well as in most developing countries. Improvement of hygiene conditions will decrease this prevalence.
La Tunisie médicale 04/2003; 81(3):200-4.
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ABSTRACT: Autoimmune hepatitis (AIH) and primary biliary cirrhosis (PBC) are two different liver diseases, however diagnosis criteria of these two affections can be found in a same patient. The aim of this study is to relate the clinical, serologic and histologic features of patients presenting the overlap syndrome, AIH-PBC, defined by the presence of at least of two main criteria of each disease and to evaluate their response to therapy.
This was a retrospective study concerning patients presenting overlap syndrome diagnosed between January 1998 and December 2001. These patients had been treated with ursodesoxycholic acid (AUDC) or prednisone and azathioprine or a combination of these three products. Clinical and biological criteria were used to assess response to therapy.
Five patients fulfilled the diagnostic criteria of overlap syndrome. All patients were females, the median age was 38 years (range: 19-65 years). Three patients were treated by UDCA, a clinical and biological response was noted in only one patient. Two patients were treated by prednisone and azathioprine without any remission. Three patients were treated by a combination of these three products with a good response in two cases.
Optimal treatment for overlap AIH-PBC syndrome remains to be determined. Treatment with UDCA or immunosuppressor alone is not efficient. A combination of these drugs should be evaluated in further studies.
Annales de medecine interne 03/2003; 154(1):7-11.
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ABSTRACT: The aim of our study was to evaluate, the prevalence of Helicobacter pylori infection in duodenal ulcer tunisian patients not using non steroidal anti inflammatory drugs. Seventy eight patients having a non complicated duodenal ulcer and not using non steroidal anti inflammatory drugs were enrolled in this prospective study carried out between February 2000 and January 2001. Six gastric biopsies were undertaken in all patients; five for an histologic analysis and one for urease test. A serum sample was taken for a Helicobacter pylori serology. Patients were considered infected if two tests were positive. Helicobacter pylori infection was present in 77 patients (98.7%). Helicobacter pylori infection is still high among patients with a non complicated duodenal ulcer and not using non steroidal anti inflammatory drugs suggesting an empirical Helicobacter pylori eradication therapy in this group of patients.
La Tunisie médicale 11/2002; 80(10):599-604.
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ABSTRACT: The use of non steroidal anti-inflammatory drugs (NSAIDs) is tempered by the development of side effects primarily in the gastro-intestinal tract. These effects result mainly from inhibition of the enzyme cyclo-oxygenase (COX)-1. Two NSAIDs (celecoxib and rofecoxib) COX-2 specific inhibitors had considerably lower ulcerogenic rates and lower serious gastro-intestinal side effects when compared with other NSAIDs used in rheumatoid arthritis and osteoarthritis. However, the exact place of COX-2 specific inhibitors remain to be determined as compared with the association of other NSAIDs and proton-pump inhibitors in the elderly. The efficacy of COX-2 specific inhibitors in digestive tumors is still unclear.
La Tunisie médicale 09/2002; 80(8):427-33.