Value of water enema computed tomography in elderly symptomatic patients.

Background And Study Aims: Colonoscopy remains the gold standard for the examination of the colon. However, its use in the elderly is not well tolerated, and there is often a need for general anaesthesia, thus increasing the risk, especially if there are co-morbidities. Water enema computed tomography has been suggested to be a satisfactory alternative as a non-invasive, fast and effective means for the diagnosis of colorectal supra-centimetric lesions.

Gastric Schwannoma: A Case Report.

Schwannomas are generally benign, slow growing tumors. They are rarely observed in the gastrointestinal tract with the most common site being the stomach. These tumors are usually asymptomatic.

Budd-Chiari Syndrome: An Unusual Presentation of Multisystemic Sarcoidosis.

Sarcoidosis is a multisystem granulomatous disease of unknown origin. All organs may be affected. Liver involvement is common but it is rarely symptomatic.

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.

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.

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.

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.

Retained common bile duct stones after endoscopic sphincterotomy: temporary and longterm treatment with biliary stenting.

Background: Endoscopic extraction of biliary tract stones is safe and effective. When the procedure is not successful, the use of a biliary stent can be a solution.

Aim: To prospectively analyse the usefulness of a stenting in management of biliary obstruction due to choledocolithiasis.

Variceal band ligation in the prevention of variceal bleeding: a multicenter trial.

Background/aim: Variceal bleeding is a life-threatening complication of portal hypertension with a high probability of recurrence. Treatment to prevent first bleeding or rebleeding is mandatory. The study has been aimed at investigating the effectiveness of endoscopic band ligation in preventing upper gastrointestinal bleeding in patients with portal hypertension and to establish the clinical outcome of patients.

[Survival in cirrhosis].

Background: Assessment of prognosis in patients with cirrhosis is important so as to plan their management.

Aim: To determine the survival rates and to identify indicators associated with shorter life expectancy in Tunisians patients with cirrhosis.

Methods: This is a retrospective study of in-patients with cirrhosis during a 5-years period.

[Psoas abscess as the initial manifestation of Crohn's disease. Report of 3 cases].

Background: Psoas abcess complicating Crohn's disease is a rare condition. Diagnosis remains difficult, especially when it is the first sign of Crohn's disease.

Aim: We report here 3 patients presenting with psoas abcess as the initial manifestation of the disease, among 118 patients with Crohn's disease seen between 1990 and 2006.

Virological response of Tunisians patients treated by peginterferon plus ribavirin for chronic hepatitis C: a preliminary study.

Background: Peginterferon plus ribavirin is actually the most effective therapy for chronic hepatitis C.

Aim: This study was designed to evaluate the efficacy and safety of peginterferon and ribavirin combination therapy in Tunisian patients with chronic hepatitis C and to identify predictors of response to treatment.

Methods: Fifty patients with chronic HCV infection recruited from the gastroenterology department of Habib Thameur hospital between January 2003 and March 2006 were prospectively included.

When will we change treatment in the care of patients with chronic hepatitis B?

Background: The treatment by the standard interferon is at present the only treatment recommended in Tunisia in the care of the chronic infection B.

Purpose: Estimate the biochemical and virological answer of the patients reached by a chronic hepatitis B, treated by standard interferon.

Methods: All the patients, having a chronic hepatitis B confirmed histological, hospitalised in the service of hepatho-gastroenterologie of the hospital Habib Thameur between 1990-2005, were respectively included.

[Prognostic factors for survival in cirrhosis].

Background: Assessment of prognosis in patients with cirrhosis is important so as to plan their management as well as the choice of major procedures. The aim of the present study was to determine the survival rates and to identify indicators associated with shorter life expectancy in Tunisians patients with cirrhosis.

Methods: This is a retrospective study of patients with cirrhosis admitted during 14-years period.

[Chylous ascites after pelvic irradiation for urologic malignancy].

Case: A 74-year-old woman had a history of transitional papillary carcinoma of the urethra, treated with brachytherapy and radiation therapy. She was hospitalized for exploration of chylous ascites. After a work-up, we concluded it was due to chyloperitoneum caused by a post-radiation lymphatic opening.

[Celiac disease associated with Budd-Chiari syndrome].

Introduction: Budd-Chiari syndrome is a rare disease defined by obstruction of the hepatic portal vein. Its association with celiac disease is rare.

Case: We report the case of a 28-year-old woman who presented with celiac disease associated with Budd-Chiari syndrome for which no cause could be found.

[Gastric and colonic sarcoidosis. A case report].

Sarcoidosis is a disseminated disease defined by the presence of non-caseous granulomas. Digestive localizations are rare and the stomach is the mostly affected. The diagnosis is frequently difficult.