Cystic dystrophy of the duodenal wall associated with chronic alcoholic pancreatitis. Clinical features, diagnostic procedures and therapeutic management in a retrospective multicenter series of 23 patients.

Aim Of The Study: The aim of this retrospective multicenter study was to collect data from patients with chronic alcoholic pancreatitis and cystic dystrophy of the duodenal wall in order to better understand the outcome after medical, endoscopic and/or surgical treatment.

Patients And Methods: The data from medical records of 23 patients consecutively seen in ten primary referral centers from January 1990 to July 2004 were studied. Clinical, biological, and endoscopic features as well as imaging findings were recorded.

Remission with ursodeoxycholic acid of type 1 autoimmune hepatitis resistant to azathioprine and steroids.

Combination therapy with steroids and azathioprine is the reference treatment for autoimmune hepatitis, but potential adverse effects are numerous and intolerance can occur. We report a patient with a well-documented type 1 autoimmune hepatitis intolerant to corticosteroids and azathioprine therapy, in whom eight years of ursodeoxycholic acid monotherapy was associated with biochemical and histological remission.

[Hepatitis C epidemiology at a general hospital center. Management and natural history as a function of the manner of identification].

Objectives: To study the epidemiological characteristics of patients with chronic hepatitis C virus followed in a primary referral hospital and the clinical influence of "systematic screening" defined as the screening of patients without symptoms and with known risk factors of hepatitis C (past transfusion, past or present intravenous drug use, haemodialysis) on the natural history and treatment of chronic hepatitis C virus.

Methods: The files of 311 consecutive patients who screened positive for anti-hepatitis C virus and were seen at the primary referral hospital, Creil, from January 1992 to February 1996, were analyzed.

Results: Patients who underwent "systematic screening" were younger with a shorter duration of infection.

[Acute pancreatitis and pancreatic reactions due to Salmonella. A study of 6 cases].

Numerous infectious agents may induce acute pancreatitis. We report 6 cases of Salmonella-associated acute pancreatitis. Pathogenesis of this type of pancreatitis is related to multiple factors that may coexist in the same patient.

Treatment of chronic hepatitis C with amantadine hydrochloride in patients who had not responded to previous treatment with interferon-alpha and/or ribavirin.

Seven women and 3 men infected with hepatitis C virus, all of whom had failed to respond to therapy with either IFN-alpha or IFN and ribavirin, were treated with 200 mg/day of amantadine hydrochloride for 12 months. We found a significant decrease of serum ALT activity without any decrease in virus load. These results suggest that amantadine hydrochloride should not be used as monotherapy for patients who do not respond to treatment with IFN-alpha and/or ribavirin.

Blindness following gastrointestinal haemorrhage.

Loss of vision is a rare but well known complication of distant and recurrent haemorrhage. It shares a poor prognosis, with only 10-14% of cases likely to make a complete recovery. Visual symptoms, due to ischaemic anterior optic neuropathy, vary from blurred vision to complete loss of vision in one or both eyes.

Prevalence and risk factors of bacteriuria in cirrhotic patients: a prospective case-control multicenter study in 244 patients.

Background/aims: The prevalence and risks factors of bacteriuria in cirrhotics have not been assessed by case-control study, and there are conflicting data concerning the role of liver failure and of ascites. The aims of this study were: i) to evaluate the prevalence of bacteriuria in cirrhotics, ii) to search for associated factors, iii) to evaluate the role of bladder post-void residual volume, and iv) to test the sensitivity of isolated bacteria to norfloxacin.

Methods: The prevalence and risk factors of bacteriuria on admission were determined by a multicenter prospective case-control study.

[Malignant pancreatic non-hodgkin's lymphoma manifesting as severe acute pancreatitis].

Primary non-Hodgkin's lymphoma of the pancreas is a rare disease. Its diagnosis is difficult without histological examination. In fact, clinical and imaging findings are not pathognomonic.

Atrium and paroxetine-related severe hepatitis.

Two cases of severe hepatitis in young women using Atrium and paroxetine are presented. Both patients presented jaundice, marked increase in aminotransferases activities, and pronounced prolongation in prothrombin time. In both cases, liver biopsy specimen examination revealed lesions compatible with drug-related injury.

Acute autoimmune sensorineural hearing loss associated with Crohn's disease.

We report the sudden onset of bilateral hearing loss in a patient with Crohn's disease while the intestinal disease was quiescent. Antibodies directed against collagen type II were detected in the serum. Dramatic improvement of his hearing was observed under corticosteroid therapy.

[Treatment of malignant gastric or duodenal stenoses by the insertion of metallic prostheses under fluoroscopic control].

Purpose: To evaluate the efficacy of metallic stents for palliation of malignant gastro-duodenal stenosis.

Materials And Methods: Twenty-three patients aged from 36 to 88 years old presented with nausea, vomiting and weight loss due to duodenal (n = 16) or antro-pyloric (n = 7) malignant stenosis and underwent placement of 37 Wallstents (1 to 3 per patient) under fluoroscopic guidance.

Results: After initial stent placement 17 patients had normal food intake.

[Nodular regenerative hyperplasia associated with primary antiphospholipid syndrome].

Nodular regenerative hyperplasia of the liver is characterized by diffuse nodularity of the hepatic parenchyma without fibrotic septa. It may be related to venous or arterial obstruction in the portal tract. We report a case of primary antiphospholipid syndrome associated with nodular regenerative hyperplasia in a 45-year old woman.

[Listeria monocytogenes liver abscess. In a diabetic patient].

Most liver abscesses are caused by Enterobacteriaceae, sometimes associated with anaerobes. Listeriosis is an exceptional cause of liver abscess, usually in a context of disseminated infections. We report the case of a diabetic woman who had liver abscess due to Listeria monocytogenes.