Publications by authors named "Jean Philippe Le Mouel"
Multiple myeloma is a malignant plasma cell proliferation located in the bone marrow and bones. It can secondarily manifest with extraosseous involvement, but the gastro-intestinal tract locations are rare. We report 3 cases of gastric and colonic localizations of myeloma in two males and one female, aged 66, 71 and 77years.
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- * The biopsies showed a distinct trabecular architecture with specific cell characteristics, and immunohistochemical analysis indicated low proliferation and expression of smooth muscle markers.
- * Preoperative diagnosis is challenging due to the lack of typical imaging features, and while there's no established treatment consensus, endoscopic resection is recommended for small tumors as a less invasive option.
Article Synopsis
- Endoscopic treatment for enterocutaneous fistulas in Crohn's disease shows promise, with a short-term clinical success rate of 75% in this study of 8 patients.
- Most patients had fistulas located at ileocolonic or colocolonic anastomoses, with various endoscopic techniques successfully applied.
- Limitations include the small sample size and retrospective design, suggesting further research is necessary to validate the findings.
Article Synopsis
- Management of colorectal stricture in inflammatory bowel disease (IBD) is complex due to potential neoplastic issues that aren't ruled out even with negative biopsies.
- Surgery is the primary treatment for strictures but carries significant risks, while recent advances in biologics and therapeutic endoscopy have not been well studied for this specific issue.
- A literature review has been conducted to improve decision-making regarding the understanding and treatment of colonic strictures in IBD, given the lack of solid evidence in current therapeutic strategies.
Prospective evaluation of third-generation small bowel capsule endoscopy videos by independent readers demonstrates poor reproducibility of cleanliness classifications.
Clin Res Hepatol Gastroenterol
November 2021
Objective: The detection of lesions during small bowel (SB) capsule endoscopy (CE) depends on the cleanliness of the intestine. Quality reporting and comparison of different preparation methods require reliable scores. Three scores known as quantitative index (QI), qualitative evaluation (QE), and overall adequacy assessment (OAA), have been proposed to assess SB cleanliness, and are sometimes used in clinical practice and in clinical trials.
View Article and Find Full Text PDFBackground: Cleanliness scores in small-bowel capsule endoscopy (SBCE) have poor reproducibility. The aim of this study was to evaluate a neural network-based algorithm for automated assessment of small-bowel cleanliness during capsule endoscopy.
Methods: 600 normal third-generation SBCE still frames were categorized as "adequate" or "inadequate" in terms of cleanliness by three expert readers, according to a 10-point scale, and served as a training database.
Purpose: To demonstrate the feasibility and safety of PTE-RV performed in a single session.
Materials And Methods: This is a retrospective review of a prospective database on ERCP between January 2014 and December 2018. PTE-RV was performed in case of second ERCP failure.
Background: The objective of this study was to compare the results of transcatheter arterial embolization (TAE) with surgery in terms of efficacy in the context of bleeding duodenal ulcer (BDU) refractory to endoscopic treatment.
Materials And Methods: From January 2006 to December 2016, all patients treated for a BDU refractory to endoscopic treatment were included in this observational, comparative, retrospective, single-center study. Primary endpoint was the overall success of treatment of BDU requiring surgical and/or TAE.
Article Synopsis
- Epinephric diverticula are linked with esophageal motility disorders, traditionally requiring surgery with notable risks; however, flexible endoscopy offers a safer alternative, as demonstrated in seven cases using the D-POEM technique.
- The D-POEM procedure involved a series of steps, including mucosal incision and submucosal dissection, with successful completion in all patients without complications; notable clinical improvement was observed in 85% of cases.
- The study suggests that D-POEM is an effective and minimally invasive option for treating esophageal motility disorders associated with diverticula, particularly benefiting patients who may not be suitable for surgery.
Article Synopsis
- Capsule endoscopy (CE) is the leading technique for examining the small bowel, but analyzing the extensive video data, averaging 50,000 frames, can take 30 to 60 minutes per video.
- The CAD-CAP database was created from third-generation SB-CE videos collected from 12 French endoscopy centers to aid in developing computer-assisted diagnosis tools for this labor-intensive reading process.
- The database contains 4,174 SB-CE videos, with 1,480 showing pathological findings, leading to the extraction and categorization of over 5,000 frames of various lesions and 20,000 normal frames for training and validation of automated detection tools.
We report the case of a 48-year-old woman treated for a gastrointestinal stroma tumor of the duodenum after presenting with upper gastrointestinal bleeding. She was treated with a combination of a radiological and endoscopic approach and minimally invasive surgery. During follow-up, the patient developed a second metachronous duodenal gastrointestinal stroma tumor, distinct from a local recurrence.
View Article and Find Full Text PDFBackground & Aims: Mucosal healing (MH) has been associated with good outcomes of patients with Crohn's disease (CD). It is not clear what levels of endoscopic healing, based on CD endoscopic index score (CDEIS), associate with different courses of disease progression. We assessed long-term outcomes of patients with CD according to different levels of MH.
View Article and Find Full Text PDFLong-Term Natural History of Microscopic Colitis: A Population-Based Cohort.
Clin Transl Gastroenterol
September 2019
Objectives: Data on long-term natural history of microscopic colitis (MC), including collagenous (CC) and lymphocytic colitis (LC), are lacking.
Methods: All new cases of MC diagnosed in the Somme area, France, between January 1, 2005, and December 31, 2007, were prospectively included. Colonic biopsies from all patients were reviewed by a group of 4 gastrointestinal pathologist experts to assess the diagnosis of CC or LC.
Introduction: Up to 25% of patients treated with infliximab experience hypersensitivity reactions. Prophylactic premedication prior to infliximab infusion, comprising corticosteroids and/or antihistamines, is widely used in clinical practice but its efficacy has recently been called into question due to the lack of pathophysiological rationale and validation by controlled trials.
Materials And Methods: We conducted a comprehensive literature search of multiple electronic databases from inception to June 2017 to identify studies reporting the impact of corticosteroid and/or antihistamine premedication on the risk of acute (<24 h) hypersensitivity reaction to infliximab in immune-mediated inflammatory diseases (IMIDs).
Gastric Obstruction Secondary to an Unexplained Hyperinflation of an Intragastric Balloon.
Clin Gastroenterol Hepatol
February 2020