Sessile Serrated Lesion of the Appendix in a Teenage Girl.

According to the literature, serrated lesions and polyps of the appendix are extremely rare in children or teenagers. Herein, we present the pathologic and molecular features of a sessile serrated lesion (SSL) that was incidentally found in the appendix of a teenage girl. Our findings not only illustrate that appendiceal SSL may occur in young patients such as teenagers but also confirm further that V600E mutation may be found in a subset of these neoplastic lesions.

A case of unusual histiocytic colitis in a chronic alcoholic obese patient with ankylosing spondylitis.

A 64 year-old Caucasian man was first investigated 21 years ago for persistent diarrhoea. A colonoscopy revealed an erosive pancolitis with unusual vacuolated macrophages. Characteristics of ulcerative colitis or Crohn's disease were absent.

Cholestatic hepatitis after diagnostic ajmaline challenge.

We report a cholestatic hepatitis in an elderly woman after ajmaline challenge during electrophysiological testing for Brugada syndrome. No other medication was reported in the previous 6 months of the onset of jaundice. Liver biopsy showed a cholestatic hepatitis with mild biliary damage.

Multiple myeloma presenting as hepatic nodular lesion.

The diffuse infiltration by plasma cells in the liver is not uncommon in multiple myeloma (MM). However, a MM with hepatic mass is very unusual. We report a case of a 75-year-old male with hepatomegaly and a lesion occupying a voluminous space in the liver.

Chronic stomal variceal bleeding after colonic surgery in patients with portal hypertension: efficacy of beta-blocking agents?

In patients with portal hypertension, ileostomy or colostomy carries the risk of the development of stomal varices at the site of the mucocutaneous junction of a stoma. Such varices are often the source of difficult-to-treat recurrent or chronic bleeding. In this setting, transjugular intrahepatic portosystemic shunt insertion and embolisation is considered the best therapeutic approach in spite of relatively high mortality and morbidity rates.

[Drainage-lavage and closure of a late esophageal perforation with esophagopleural fistula and encysted pleural effusion after endoscopic injection sclerotherapy for varices].

We report a case of late perforation of the thoracic esophagus with an esophagopleural fistula after endoscopic sclerotherapy for esophageal varices in a Child-Pugh B9 cirrhotic patient. The existence of a thoracic empyema without diffuse mediastinitis allowed management of the fistula by percutaneous drainage-lavage and antibiotic therapy with subsequent closure of the esophageal wall defect and recovery from sepsis. This observation indicates that minimally invasive management of an esophageal perforation complicated by an esophago-pleural fistula is possible in highly selected patients.

Transjugular liver biopsy. An experience based on 500 procedures.

We report our experience based on 500 transjugular liver biopsies, a safe procedure even in high risk patients. Transjugular liver biopsies represents one third of all liver biopsies performed in our Hepato-Gastroenterology units. Liver specimen was adequate to evaluate liver architecture in 87.

[Hemobilia disclosing very small hepatocellular carcinoma ruptured into the biliary ducts].

In hepatocellular carcinoma, invasion of the biliary tree usually occurs in large tumors. We report a case of a minute hepatocellular carcinoma which invaded the biliary tree and was revealed by secondary hemobilia, in a 65-old alcoholic patient with cirrhosis. The tumour was not identified by preoperative morphological examinations.

Liver injury related to amoxycillin-clavulanic acid: interlobular bile-duct lesions and extrahepatic manifestations.

We report eight cases of liver injury related to amoxycillin-clavulanate. Liver biopsy performed in seven patients revealed varying degrees of injury to interlobular bile ducts in all cases. Lesions included irregularity of the nuclei, vacuolization of the cytoplasm, lymphocytic infiltration, destruction and endothelialization of the bile duct epithelium.

Omeprazole in the treatment of patients with severe reflux oesophagitis not responding to H2-receptor antagonists and ineligible for surgery.

In 42 patients (25 men, 17 women, mean age 62 years) with severe erosive or ulcerative oesophagitis not responding to H2-receptor antagonist treatment over at least 3 months and ineligible for surgery, omeprazole was administered at an initial dose of 40 mg/day, subsequently reduced to 20 mg after healing of the lesions. Patients had monthly clinical, endoscopic, histological and laboratory assessment over the healing period, then were reevaluated 3-monthly over one year, then 6-monthly, during the maintenance treatment. Stages of oesophagitis were based on the Savary-Miller classification, modified for stage I (erosions must be present).

[Treatment of familial rectocolonic polyposis with total colectomy using ileorectal anastomosis in 6 members of a family: the value of early diagnosis].

We report on the observation of six cases in a family of eight, all under 30, in whom the diagnosis was obtained at first hand by rectosigmoidoscopy. This procedure appears sufficient as the number of polyps tends to decrease with increasing distance from the anal margin. The recent finding of abnormalities of chromosome 5 (long arm) permits the identification of carriers of this genotype by simple blood examination (DNA probe), thus greatly enhancing the possibilities of screening for the disease.