[Metabolism and therapeutic monitoring of azathioprine in gastroenterology and hepatology].

Azathioprine keeps an important place in the treatment of inflammatory bowel disease and autoimmune hepatitis. This molecule has a narrow therapeutic margin, associated with a risk of toxicity, particularly hematological and hepatic. Its complex metabolism is subject to genetic polymorphisms that are reflected in the inter-individual variability observed in the response to treatment and its tolerance profile.

D-lactic acidosis in humans: systematic literature review.

Background: D-lactic acidosis is an uncommon and challenging form of metabolic acidosis that may develop in short bowel syndrome. It has been documented exclusively in case reports and small case series.

Methods: We performed a review of the literature in the National Library of Medicine and Excerpta Medica databases.

[Bilio-digestive fistula with an unusual etiology].

On the basis of one case, the authors give the highlights on the various clinicopathological features of malignant gastric perforations. While medical imaging does not seem to contribute much in the positive diagnosis of such complications, it does remain essential to establish the local extension of the tumour process and thus to allow a better therapeutic management.

[Primary malignant fibrous histiocytoma of the lung].

On the basis of one personal case, the various clinicopathological features of primary malignant fibrous histiocytoma of the lung are summed up. This tumor, which has a nonspecific radiological appearance, most often appears as a large peripheral pulmonary opacity, for which the prognosis is guarded and the positive diagnosis based on surgical exeresis or biopsy.

[Primary sarcoma of the pulmonary artery].

On the basis of one personal case of leiomyosarcoma, the various anatomicoclinical features of sarcomas of the pulmonary artery are summed up. They most often produce a picture of severe pulmonary embolism that is resistant to all treatments; the lesion most often is a hilar mass without any associated bronchoscopic abnormality. Angiograms are not always easily interpreted, and the modern imaging techniques (ultrasound, computed tomography, and above all MRI) can best lead to the preoperative diagnosis, although this lesion is unfrequent.