Sinonasal involvement as a rare extraintestinal manifestation of Crohn's disease.

Crohn's disease is a chronic idiopathic slowly developing transmural inflammation of the digestive system. It usually involves the small intestine and/or the area around the anus but can also affect the entire gastrointestinal tract anywhere from the mouth to the anus. Extra intestinal manifestations occur frequently and multiple organ systems may be affected: the skin, joints, spine, eyes, liver and bile ducts.

Report on the Belgian consensus meeting on colorectal cancer screening.

Screening and prevention of colorectal cancer must be a public health priority. It is the most frequent malignancy in Europe, the second leading cause of cancer death, including Belgium where more than 6000 new cases occur per year. Various screening modalities, from non invasive to invasive are available and currently in use and they are all cost-effective in comparison with no screening.

Oesophageal self expanding metal stents. Preliminary report about covered and non-covered types.

Objective: The aim of this study was to evaluate the effectiveness and complications rate of covered and non-covered self expanding metal stents in the palliative treatment of oesophageal dysphagia.

Design: In this retrospective non-randomized study, we evaluated 11 non-covered and 17 covered stents of different types.

Results: Grade of dysphagia and improvement after treatment were similar in both groups, all the seven fistulas were sealed by covered stents.

Endoscopic therapy of Barrett's oesophagus: critical review.

Barrett's oesophagus is known as one of the most important risk factor of oesophageal adenocarcinoma. Because of the increasing incidence of these latter, many endoscopic methods such as argon plasma coagulation, photodynamic therapy or endoscopic mucosal resection are now in evaluation in order to eradicate Barrett's oesophagus or to treat dysplasia and early cancers arising from this metaplasia. The aim of this paper is to comment these techniques and discuss their usefulness.

Granulomatous bronchiolitis associated with Crohn's disease.

Symptomatic bronchopulmonary disorders have been only occasionally reported in Crohn's disease, although several studies have documented the possibility of latent involvement of the respiratory tract. We report the case of a patient with long-standing Crohn's disease who presented with acute transient chest pain and a recent history of mild dyspnea and nonproductive cough. Chest radiographs were normal, while high-resolution computed tomography demonstrated a mosaic pattern of attenuation that was consistent with a bronchiolar disorder.

The 1998 national Belgian consensus meeting on HP-related diseases: an extensive summary. The HP Belgian contact group organized in CHU Brugmann, Brussels.

"HP testing must be regarded as ONE of the important elements of the proper diagnostic work-up of a DISEASE, managed in close cooperation between GP's and specialists": that's the key message of the national consensus meeting held in CHU Brugmann on February 6th and 7th 1998. HP testing (usually by 2 direct methods: RUT-histology) and eradication treatment (ER), in infected patients, are strongly recommended in: 1. Past or current GDU (absolute indication), regardless of activity, complication(s), NSAID intake; 2.

Mesenterico-left intrahepatic portal vein shunt: original technique to treat symptomatic extrahepatic portal hypertension.

Unlabelled: MESENTERICO-LEFT INTRAHEPATIC PORTAL VEIN SHUNT: Original technique to treat symptomatic extrahepatic portal hypertension.

Objective: Revascularization of the intrahepatic portal system as decompressive surgery for chronic extrahepatic portal hypertension.

Summary Background Data: In patients with extrahepatic portal hypertension (portal trunk thrombosis in presence of a normal liver), shunt surgery is indicated when patient is bleeding from varices at a site not accessible for the endoscopist.

Intraductal papillary-mucinous tumours of the pancreas. Clinical and radiological aspects.

Intraductal papillary-mucinous tumours are rare epithelial tumours with all intermediate types occurring from papillary to mucin-hypersecreting forms. They affects generally old men and recurring pancreatitis is the main clinical feature. Endoscopic Retrograde Pancreatography is the best diagnostic method, showing large dilatation of the ducts and filling defects due to mucin's plugs or papillary tumour.

[Pneumatosis cystoides intestinalis associated with Steinert disease].

We report the case of a 63-year-old patient suffering from myotonic dystrophy, complicated with respiratory insufficiency, who presented a pneumoperitoneum without sign of peritonitis. Diagnosis of pneumatosis cystoides coli was based on CT scan evidence. Given oxygenotherapy and antibiotherapy, the patient rapidly improved.

The clinical [corrected] background of familial adenomatous polyposis. History, epidemiology, diagnosis and treatment.

Familial adenomatous polyposis (FAP) is a dominantly inherited genetic disorder predisposing to colon cancer through the early development of multiple adenomatous polyps in the large bowel. FAP is not restricted to the colon and rectum, but is a more complex disease which can potentially affect almost any organ not only with benign tumours but also with life threatening carcinomas. Desmoid tumours and gastroduodenal polyps and cancer are the two more worrying extracolonic manifestations of FAP.

Dyskinesia of the superior oesophageal sphincter: assessment and treatment.

Pharyngo-oesophageal dyskinesias present a common symptomatology associated with those difficulties in swallowing for which the radio-manometric assessment is well known. Radiology, nevertheless, with an overall analysis of deglutition and its iatrogenic complications, as well as manometry of the superior oesophageal sphincter (OSS) with its diversity of results, according to the material, techniques, age, sex and stress involved, has convinced us of the necessity for a supplementary dynamic examination. Electromyography (EMG), simultaneously by the inferior constrictor (IC) and cricopharyngeal (CP) muscles, analyses with precision the electric activity of these two muscles, as well as the pharyngosphincteral synchronism.

Thrombosis of splenic artery pseudoaneurysm complicating pancreatitis.

The natural history of pseudoaneurysms complicating pancreatitis is unknown. A patient with chronic pancreatitis is described in whom thrombosis of a splenic artery pseudoaneurysm occurred. Early diagnosis and radical treatment of a bleeding pseudoaneurysm are mandatory.

Anal fissure: correlation between symptoms and manometry before and after surgery.

The study compared symptoms and manometric results in 76 patients (42 men and 34 women; median age: 45 years) before and at long-term follow-up (median time: 54 months) after fissurectomy with posterior midline sphincterotomy for anal fissure. The fissure healed in all cases. Sporadic loss of continence for flatus or for liquid stool occurred in 21 patients (27.

Regenerative nodules in hepatic cirrhosis. Value of gradient-echo MR imaging with a surface coil.

To evaluate the accuracy of surface coil gradient-echo (GRE) imaging in the detection of regenerative nodules of hepatic cirrhosis, 53 patients with diffuse liver disease, among whom 31 had cirrhosis, were prospectively investigated. Three GRE sequences acquired with a surface coil were used in the study: a T2*-weighted, a T1-weighted, and a gadopentetate-enhanced sequence. ROC analysis showed that two surface coil GRE sequences were superior to conventional T2-weighted spin-echo imaging acquired with a body coil for the detection of regenerative nodules.

Focal nodular hyperplasia in association with spontaneous intrahepatic portosystemic venous shunt.

We report a case of focal nodular hyperplasia in an adolescent with a spontaneous intrahepatic portosystemic venous shunt. Diagnosis was established by duplex and color Doppler ultrasound, computed tomography, magnetic resonance imaging, and histology. This association further supports the hypothesis that focal nodular hyperplasia is a response to a preexisting vascular abnormality.

[Distomatosis of the bile ducts. Value of retrograde cholangiography. Efficacy of triclabendazole].

A case of chronic biliary fascioliasis is reported, which was confirmed by endoscopic retrograde cholangiography. After unsuccessful attempts of treatment with classic antiparasitic drugs, cure was obtained with triclabendazole the absorption of which was studied.

[Acute dilatation of the colon].

Dilated colon is provoked by obstructing lesions, toxic megacolon or colonic pseudoobstruction. The obstructing lesions of the colon are colonic volvulus, inflammatory bowel disease with stenosis or colonic cancer. Toxic megacolon is more often caused by I.

[Pharyngo-laryngeal consequences of gastroesophageal reflux. Value of esophageal pH measurements in 74 patients].

Ambulatory 24 hour oesophageal pH monitoring was performed in order to detect gastro-oesophageal reflux disease (GERD) in 74 patients presenting with poorly explained ear-nose-throat complaints. A significant number of these patients also benefited from other currently used methods for diagnosing GERD. Oesophageal pH-monitoring demonstrated GERD in half of the patients.

Alcoholic liver disease: value of the left-to-right portal vein ratio in its sonographic diagnosis.

A study group of 50 patients in whom the left portal vein diameter was equal to or greater than the right portal vein diameter (LPVD greater than or equal to RPVD) was prospectively compared on ultrasonography with a control group of 50 patients with LPVD less than RPVD. Clinical and laboratory data indicating chronic alcoholic liver disease (CALD) were observed with a significantly higher frequency in the study group than in the control group. It emerges from this study that LPVD greater than or equal to RPVD represents a useful ultrasonographic sign of CALD, corresponding to a relative enlargement of the left hepatic lobe compared with the right.