Tenascin-W Is a Novel Stromal Marker in Biliary Tract Cancers.

Extrahepatic cancers of the biliary system are typically asymptomatic until after metastasis, which contributes to their poor prognosis. Here we examined intrahepatic cholangiocarcinomas (n = 8), carcinomas of perihilar bile ducts (n = 7), carcinomas of the gallbladder (n = 11) and hepatic metastasis from carcinomas of the gallbladder (n = 4) for the expression of the extracellular matrix glycoproteins tenascin-C and tenascin-W. Anti-tenascin-C and anti-tenascin-W immunoreactivity was found in all biliary tract tumors examined.

Emergency surgery for Crohn's disease.

Background: Surgery has played an essential role in the treatment of Crohn's disease. Emergency can reveal previously unknown complications whose treatment affects prognosis.

Purpose Of Study: Indicate the incidence of indications in emergent surgery for Crohn's disease.

Prognosis of refractory ascites in cirrhosis.

Background: Ascitic decompensation is a common major complication of cirrhosis and is associated with a poor outcome. In 5-10% of patients, ascites become resistant to treatment (either do not respond to a high dose of diuretics or because these drugs induce complications), which is called refractory ascites (RA). RA is associated with poor survival: 20-50% at 1 year.

Appropriateness of indication for upper gastrointestinal endoscopy in a Tunisian endoscopy unit.

Background: Upper gastrointestinal endoscopy (UGE) is an increasing and reliable procedure. Given the high costs and potential risks, appropriate indication of UGE may be facilitated by referring to qualifying criteria such as those devised by the European Panel (EPAGE). This prospective study evaluates the applicability and efficacy of these criteria in clinical practice.

Surgical treatment of Crohn's disease: indications, results and predictive factors of recurrence and morbidity.

Background: Crohn's disease management represents a major problem in gastroenterology and general surgery because it affects young subjects and has a major impact on their quality of life. The aims of our study were to identify the indications for surgery in Crohn's disease, the results and the complications of surgery in our series, and to identify possible predictive factors of recurrence and postoperative morbidity.

Methods: A retrospective descriptive study including 38 cases of patients with Crohn's disease who underwent surgical treatment in the department of surgery in Mongi Slim Hospital, during the period between January 1992 and December 2011 was performed.

Complete radiological response after sorafenib treatment for advanced hepato-cellular carcinoma.

Introduction: Sorafenib, an oral multikinase inhibitor, has recentlybeen shown to improve overall survival in patients with advanced hepatocellular carcinoma (HCC) but only a handful of reports of complete remission on sorafenib have been issued.

Case Report: We report an intriguing case of advanced HCC complicating HCV infection with cirrhosis, in which the patient achieved complete remission by prolonged administration of sorafenib.

Conclusion: Identifying factors that could be associated with good response to this therapy are needed.

[Nocturnal gastroesophageal reflux. About a pH metric series].

Background: Nocturnal gastroesophageal reflux has been shown to be associated with the more severe forms of gastroesophageal reflux disease (GERD), particularly with extraesophageal manifestations as well as complications of mucosal damage.

Aim: To determine the frequency of nocturnal gastro esophageal reflux disease on 24-hour esophageal pH monitoring in patients with digestives or extra-digestives symptoms and to evaluate the clinical and pHmetric characteristics of nocturnal reflux in these patients.

Methods: We conducted a retrospective study based on results of 24- hour esophageal pH monitoring during a 11-year period in patients with or without digestive symptoms of gastroesophageal reflux disease.

Solid pseudopapillary tumor of the pancreas with concomitant Bochdalek's hernia. The first reported case.

Background: Solid pseudopapillary tumors of the pancreas are rare. The diagnosis is difficult because of its clinical and radiological polymorphism. It was described in the literature that this entity can be associated with congenital malformation.

Quality indicators for colonoscopy in a Tunisian endoscopy unit.

Background: Colonoscopy is a powerful tool for prevention and early diagnosis of colorectal cancer. However, the effectiveness of colonoscopy is dependent on the quality of the procedure, which is assessed by a number of key quality indicators. Among them, cecal intubation and adenoma detection rate are historically the most commonly used indicators of quality of colonoscopy.

Percutaneous treatment versus hepatic resection for the treatment of small hepatocellular carcinoma.

Background: Hepatocellular carcinoma is the first liver tumor worldwide. Therefore, it is a matter of debate whether surgical treatment or percutaneous treatment should be preferred for the treatment of patients with small hepatocellular carcinoma. The aim of our study was to compare the long-term outcome and the survival between surgically and percutaneously treated small hepatocellular carcinomas.

[Chronic pancreatitis: clinical and therapeutic study. Six years of experience of a gastroenterology department].

Background: The chronic pancreatitis is an inflammatory chronic affection of the pancreatic parenchyma characterized by a mutilating fibrosis with a progressive set up. The endoscopic treatment is actually considered as the first-line treatment and can sometimes be complementary to surgery.

Aim: To determine the epidemiological, clinical, para-clinical and therapeutic characteristics during chronic pancreatitis.

[Solitary rectal ulcer syndrome. A Tunisian monocentric Survey].

Background: Solitary rectal ulcer syndrome is an uncommon and benign defecation disorder. Occidental series are scarce and to our knowledge, Tunisian data are not available.

Aims: The aim of this study was to evaluate the clinical, endoscopic and histological spectrum of the solitary rectal ulcer syndrome.

Risk factors of psychological disorders in inflammatory bowel disease in a tunisian survey. Results of a cross-sectional study.

Background: Little is known in inflammatory bowel disease (IBD) regarding risk factors for psychological distress. The aims of our work were to evaluate the frequency of anxiety and depression among patients with IBD and to determine the factors associated with these psychological disorders in Tunisian patients.

Methods: From June 2012 to April 2013, 60 consecutive patients with IBD answered a questionnaire about psychological and socioeconomic factors and adherence to treatment.

Percutaneous treatment versus hepatic resection for the treatment of small hepatocellular carcinoma.

Background: Hepatocellular carcinoma is the first liver tumor worldwide. Therefore, it is a matter of debate whether surgical treatment or percutaneous treatment should be preferred for the treatment of patients with small hepatocellular carcinoma. The aim of our study was to compare the long-term outcome and the survival between surgically and percutaneously treated small hepatocellular carcinomas.

[What's new in rectal cancer?].

Background: In recent years, multidisciplinary therapeutic management of rectal cancer has evolved. This progress had interest radio and chemotherapy.

Aim: To describe the main spots of the progress in the therapeutic strategies of the disease, surgical techniques and standardization of these techniques, particularly regarding locoregional extension in the mesorectum.

Ischemic colitis in five points: an update 2013.

Background: Ischemic colitis is the most common form of intestinal ischemia. The presence of diarrhea and mild lower gastrointestinal bleeding should guide the diagnosis. Although many laboratory tests and radiographic images may suggest the diagnosis, colonic endoscopic with histological analysis of biopsies is the gold standard for identification of colonic ischemia.

Toxic megacolon complicating a first course of Crohn's disease: about two cases.

Toxic megacolon is a rare and serious complication of Crohn's disease. Because of the associated high morbidity and mortality, early recognition and management of toxic megacolon is important. Through two cases of toxic megacolon complicating Crohn's disease, we assessed the clinical, radiologic and therapeutic characteristics of this complication.

Gender difference in patients with hepatocellular carcinoma.

Background: Hepatocellular carcinoma represents the fifth most common cancer worldwide and account for approximately 90% of primary liver cancer. Men have a higher prevalence than women; the sex ratio varies between 2:1 and 4:1, depending on the geographic region.

Aim: To determine the influence of gender on the clinicopathologic characteristics and survival of patients with hepatocellular carcinoma.

The Budd-Chiari syndrome.

Background: The Budd-Chiari syndrome is a rare disease, often fatal if not treated optimally. It is characterized by a blocked hepatic venous outflow tract. aim: This review attempted to present pathophysiology, aetiologies,diagnosis and therapeutic modalities of the Budd-Chiari syndrome.