Current Issue : January-March Volume : 2026 Issue Number : 1 Articles : 7 Articles
Background: Crohn’s disease is a chronic inflammatory bowel disorder with complex and multifactorial pathogenesis and presentations. This retrospective study aims to analyze the biological abnormalities observed at the initial diagnosis of Crohn’s disease in a cohort of 231 patients. Methods: We performed a five-year retrospective study at the Hepato-Gastroenterology Department of University Hospital Hassan II in Fez, Morocco, involving 231 patients diagnosed with Crohn’s disease. A standardized form was used to extract data from medical charts and the Hosix electronic medical system. With an emphasis on hematologic, inflammatory, and nutritional parameters, as well as superinfections at presentation, demographic, clinical, and paraclinical variables were gathered. Results: The cohort’s mean age was 37.8 ± 12.2 years, and the majority of participants (66.7%) were female. Seventy-seven percent of patients had a chronic disease onset when they first arrived, and the average diagnostic delay was 16.7 months. 1) Inflammatory markers: Of the 196 patients tested, 91.8% had elevated fecal calprotectin (74.8% had >250 μg/g), and 83% had elevated C-reactive protein. 2) Anemia: Found in 61 percent of patients (n = 139), primarily microcytic hypochromic; 20 percent had iron deficiency, 44.6 percent had inflammation, and 35.4 percent had mixed. 3) Nutritional deficiencies were prevalent and included hypoalbuminemia (59%), vitamin D deficiency (90%), and hypocalcemia (39%), as well as hypomagnesemia (17%). 4) 24.8 percent of patients experienced superinfections, primarily from Entamoeba histolytica (14 percent) and Clostridium difficile (9.2 percent). Conclusion: These results highlight how Crohn’s disease affects more than just the gastrointestinal tract. To improve patient outcomes and optimize management strategies, routine evaluation of inflammatory markers, hematological parameters, and nutritional status are essential....
Chylous ascites is an infrequent clinical entity, characterized by the presence of ascitic fluid with a milky appearance, containing triglyceride levels above 1000 mg/dL or 2 to 8 times higher than the plasma triglyceride value. This paper reports the clinical case of a 61-year-old female patient with cirrhosis of viral etiology (hepatitis C virus), with a history of worsening ascites and milky ascitic fluid on paracentesis....
Introduction: Esophagogastroduodenoscopy (EGD) is the first-line investigation for patients presenting with dysphagia. It offers both diagnostic and therapeutic benefits. The aim of this study was to assess the role of EGD in the management of dysphagia. Patients and Methods: This retrospective, descriptive, multicenter study was conducted from 1st March 2021 to 31 July 2022. All patients with an indication for EOGD due to dysphagia were included. Socio-demographic information, endoscopy indications and findings, lesion anatomopathology, and the endoscopic treatments performed were collected and analyzed using Epi Info version 7.2.6.0 and R 4.4.0. Results: The prevalence of dysphagia was 6.8%. The mean age was 46 years (range: 2 - 93 years), with a sex ratio of 0.8 (180 women). Dysphagia was classified as high in 51.8% of cases, was of organic origin in 97.6% of cases, and chronic in 50% of cases. It was primarily associated with epigastric pain (11.4%) and gastroesophageal reflux disease (GERD) (4.9%). Etiologies of dysphagia were identified in 184 patients (56.8%). The principal lesions observed included rings (29.4%), esophageal tumors (25.5%), esophageal candidiasis (15.8%), and peptic lesions (12.5%). Savary-Guilliard bougie dilation was performed in 31.5% of cases. Conclusion: EOGD occupies a central role in the management of dysphagia. It has made it possible to identify the etiology in the majority of cases and to treat it in some cases....
Introduction: Peptic ulcer disease (PUD) results from an imbalance between aggressive and protective factors of the gastric and duodenal mucosa. Helicobacter pylori (H. pylori ) is a common etiology. However, the African paradox exists, where the WHO-estimated 80% prevalence of H. pylori is not statistically associated with a high frequency of PUD. This study aimed to investigate the relationship between H. pylori and PUD in Libreville. Methodology: We conducted a 3-year prospective study (2017-2019) at the Libreville University Teaching Hospital (CHUL), including 167 patients with PUD confirmed by endoscopy and biopsies. Epidemiological, clinical, therapeutic, and histological data were analyzed using Epi Info 7.2, with statistical tests (Chi-square, Fisher). Result: H. pylori was present in 79.3% of patients. PUD predominantly occurred in patients with low socioeconomic status (66.5%). Regarding patients with negative H. pylori , there was a significant association with NSAID use (p = 0.0001), stress (p = 0.0108), and alcohol consumption (p = 0.0242). Gastric ulcers (61.1%) were most frequent, with chronic gastritis (89.2%) as the predominant histological lesion. Conclusion: While H. pylori remains a major factor in peptic ulcer in Libreville, our study highlights the important role of NSAIDs, stress, and alcohol. These findings underscore an epidemiological shift and call for integrated management strategies addressing both infectious and non-infectious risk factors....
Background: The treatment of ulcerative colitis (UC) has evolved significantly with the introduction of biotherapies and advanced endoscopic techniques, reducing the need for surgical intervention. However, surgery remains essential in cases of severe acute colitis, refractory disease, or complications such as toxic megacolon, perforation, or colorectal cancer. Methods: We conducted a retrospective analysis of 81 patients who underwent ileorectal anastomosis (IRA) for ulcerative colitis between 2010 and 2023, evaluating surgical outcomes and the long-term evolution of the remaining rectum. Data were collected on disease activity in the rectum, the incidence of rectal cancer, and the need for secondary proctectomy. Results: The study included 81 patients who underwent surgery for ulcerative colitis. The median follow-up duration was 6 years. The average age of the patients was 39 years, with a slight male predominance. Among the 81 patients, 57 (70.37%) had a prior diagnosis of ulcerative colitis, while in 24 patients (29.63%) the disease was revealed by a complication that immediately required colectomy. Regarding the extent of the disease, pancolitis was the most common form, found in 47 patients (58.02%). Concerning maintenance treatments administered before surgery in diagnosed patients, 22 patients (38.57%) were on azathioprine, 19 (33.33%) were receiving infliximab, and 16 (28.07%) were treated with mesalazine. The average duration of disease before surgery was 5 years. The surgical indications were mainly dominated by severe acute colitis, representing 61 cases (75.3%). Regarding surgical procedures, 68 patients (83.9%) initially underwent subtotal colectomy with ileostomy and sigmoidostomy, followed by restoration of continuity through ileorectal anastomosis. The average time to restoration of continuity was 16 months. Additionally, 13 patients (16.04%) directly underwent total colectomy with ileorectal anastomosis. Postoperatively, all patients received local enemas. Subsequently, 49 patients (60.49%) were treated with anti-TNF therapy, 27 (33.33%) with azathioprine, and 5 (6.17%) remained on enemas alone. Endoscopic evaluation of the remaining rectum, performed after surgery and initiation of maintenance therapy, revealed a Mayo score of 0 - 1 in 22 patients (27.16%), a Mayo score of 2 in 13 patients (16.04%), and a Mayo score of 3 in 46 patients (56.79%). Overall assessment of the remaining rectum’s evolution showed clinical and endoscopic remission in only 22 patients (27.16%). In contrast, 58 patients (71.60%) developed refractory proctitis, and one case of high-grade dysplasia was diagnosed. Finally, 31 patients (38.27%) required secondary proctectomy. Conclusion: The long-term outcomes of the remaining rectum are not always favorable. While some patients achieve clinical and endoscopic remission, a significant proportion develop refractory proctitis, necessitating additional interventions such as secondary proctectomy....
The aim of this study was to investigate the risk factors associated with the occurrence of portal thrombosis in cirrhotic patients at the hepatology and gastroenterology department of Cocody University Hospital. Patients and methods: This was a retrospective analytical study of the unpaired case-control type, lasting 5 years from January 2018 to December 2022, covering 117 files of cirrhotic patients, including 21 cases of portal venous thrombosis (PVT) and 96 witnesses. The risk factors studied were age, sex, Child-Pugh score, ascites, jaundice, edema of the lower limbs, digestive bleeding, hepatic encephalopathy, etiologies of liver cirrhosis, prothrombin rate, transaminases, bilirubin, albumin, endoscopic signs of portal hypertension, propranolol intake, platelets, and hemoglobin. Univariate and multivariate logistic regression analyses were used to identify risk factors associated with the occurrence of PVT. Results: The hospital prevalence of cirrhosis was 12.9%, the average age of patients was 49.2 ± 14.8 years with a male predominance (sex ratio = 1.43), and viral hepatitis B was the main cause (48.7%). Jaundice, portal hypertension, gastropathy, and anemia were the risk factors associated with the occurrence of PVT in cirrhotics in the univariate analysis. After multivariate regression, portal hypertension gastropathy (OR = 4.4; regression coefficient β = 1.59; CI = 1.6 - 12.4; p = 0.004) was significantly associated with the occurrence of PVT, while anemia was a protective factor (OR = 0.2; regression coefficient β = −1.61; CI = 0.1 - 0.9; p = 0.03). Conclusion: Patients with portal hypertension gastropathy are more likely to develop portal vein thrombosis during cirrhosis....
The purpose of this study was to investigate the regional distribution and mucosal localization of serotonin-containing endocrine cells in the pancreas and small intestine (duodenum, jejunum, and ileum) of quails. Endocrine cells in the digestive tract were identified using the immunohistochemical peroxidase– antiperoxidase (PAP) method. Most serotonin-secreting endocrine cells were observed in the basal regions of the glands, exhibiting oval or spindleshaped morphology. Two main types of endocrine cells were identified based on their contact with the intestinal lumen: open-type cells, which extend to the lumen and can sense luminal contents, and closed-type cells, which do not reach the lumen and are entirely embedded within the epithelium or glandular tissue. In the duodenal glands, some closed-type immunoreactive cells were detected, while open-type immunoreactive cells were mainly found in the lamina propria epithelium. Endocrine cells with luminal contact were present in the epithelial layer of the small intestine, whereas cells within the glands lacked such contact. Serotonin immunopositive reactions were most abundant in the duodenum, followed by a gradual decrease in the jejunum and ileum. In the pancreas, serotonin-positive cells were also detected, but at a lower density compared to the intestinal segments.. In the pancreas, serotonin-positive cells were more concentrated in the endocrine regions compared to the exocrine tissue....
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