Appropriateness of colonoscopies in a Tunisian endoscopy center: factors and EPAGE-I/II criteria comparison.

Background: There is a growing demand for colonoscopy, worldwide, resulting in increased rate of inappropriate referrals. This "overuse" of colonoscopies has become a major burden for health care.

Objectives: to assess the appropriateness of colonoscopies performed at the endoscopy unit of the university hospital of Sousse and to compare these results of appropriateness according to the European Panel of Appropriateness of Gastrointestinal Endoscopy (EPAGE) I and EPAGE II criteria.

Predictive factors of recurrence in spontaneous bacterial peritonitis in Tunisian patients with cirrhosis.

Introduction: Recurrent spontaneous bacterial peritonitis (SBP) in patients with cirrhosis is associated with poor prognosis.

Aim: To assess the prevalence and the risk factors for recurrence and to evaluate its impact on the prognosis.

Materials & Methods: We conducted a retrospective study including patients with cirrhosis having a first episode of SBP.

Predictors of postoperative recurrence in a cohort of Tunisian patients with Crohn's disease.

Background: The aim of our study was to evaluate the frequency and risk factors of clinical postoperative recurrence in Tunisian patients with Crohn's disease (CD).

Methods: Clinical data of 86 patients with CD who underwent ileocolonic resection at University Hospital of Sahloul in Tunisia were retrospectively reviewed. Continuous data are expressed as median (interquartile range), and categorical data as frequencies and percentages.

Spectrum of acute hepatitis and its clinical outcome in a central region in Tunisia.

Introduction: given the lack of studies on acute hepatitis (AH) in Tunisia, we carried out this study to find the etiological spectrum and clinical profile of AH and to investigate the impact of viral etiology on the outcomes of AH.

Methods: retrospective descriptive study collecting all patients with AH from 2010 to 2017. The data were compared between two groups (viral AH and non-viral AH).

Synchronous Hepatocellular Carcinoma in a Patient with Primary Gastric Cancer: An Exceptional Association.

Hepatocellular carcinoma (HCC) is the most frequent type of liver cancer. Liver cirrhosis of any etiology is considered the main risk factor for the development of HCC. However, HCC in noncirrhotic livers remains an uncommon finding.

Cirrhotic cardiomyopathy.

The presence of cardiocirculatory dysfunction in liver cirrhosis has been described since 1960 and it was exclusively attributed to alcoholic cardiomyopathie. Only in the last two decades, the term of cirrhotic cardiomyopathy (CCM) was introduced to describe cardiac dysfunction in patients with cirrhosis. This entity is currently underdiagnosed because the disease is usually latent and manifests when the patient is under stress.

Quality of life in inflammatory bowel disease in Tunisian patients.

Background: The management of the health-related quality of life (HRQL) is increasingly considered as an important treatment goal in chronic diseases including inflammatory bowel diseases (IBD).

Aim: The aim of our study was to determine the impact of IBD on HRQLand identify the factors involved in the deterioration of HRQL in these patients.

Methods: We conducted a case-control study including 108 patients; 66 had Crohn's disease (CD) and 42 had ulcerative colitis (UC).

Unusual case of duodenobiliary fistula complicating Crohn's disease successfully treated with Adalimumab.

Crohn's disease (CD) is characterized by transmural inflammation of the gastrointestinal tract, which predisposes to the formation of fistula. Duodenal involvement occurs in less than 5% of cases and often leads to clinically relevant strictures. However, fistula formation in the duodenum is exceptional.

Vogt-Koyanagi-Harada syndrome and Crohn's disease: an exceptional association.

Vogt-Koyanagi-Harada disease (VKH) is a rare, multisystem disease of melanocyte-containing organs. It is characterized by diffuse, granulomatous inflammation involving various organs. It has been reported to occur in association with other autoimmune disorders.

Antiphospholipid Antibodies and Procoagulant Profile in Tunisians With Inflammatory Bowel Diseases.

The hypercoagulable state accompanying inflammatory bowel diseases (IBDs) is still poorly understood. The aim of this study was to assess antiphospholipid antibodies (APAs) and a large panel of inherited and acquired thrombotic markers simultaneously in a sample of Tunisian patients with IBD. In total, 89 consecutive patients with IBD (mean age 38 ± 15 years; 48 with Crohn disease and 41 with ulcerative colitis) and 129 controls were prospectively evaluated for immunoglobulin (Ig) G, IgM, and IgA antibodies against cardiolipin (aCL), β2glycoprotein I (aβ2GPI), and prothrombin (aPT); IgG and IgM antibodies against phosphatidic acid (aPA), phosphatidylinositol (aPI), and annexin V (aAnnV); lupus anticoagulant (LA); coagulation factors; natural inhibitors; and thrombotic genetic polymorphisms.

[Prévalence de l'infection à Helicobacter pylori et des lésions endoscopiques hautes chez les diabétiques: Etude cas/témoins].

Background: Current data on the prevalence of Helicobacter pylori infection in dyspeptic diabetic patients are contradictory in the literature.

Aim: the aim was to assess the prevalence of Helicobacter pylori infection, gastroscopic lesions, and gastric histopathological lesions, in dyspeptic diabetic patients.

Methods: It was a case-control study collecting 394 dyspeptic patients (194 diabetic and 200 nondiabetic patients).

Suspected azathioprine induced liver cirrhosis: an unusual side effect.

In recent years, the hepatotoxic potential of thiopurines, in particular 6-thioguanine (6-TG) has been discussed in literature. However, cirrhosis was exceptionally reported. We report the case of a 56-year-old woman with ileocaecal Crohn's disease treated with azathioprine.

[Primary biliary cirrhosis: a retrospective study of 36 cases].

Background: Primary biliary cirrhosis is a rare cholestasis liver disease affecting the women of mature age,it association with Autoimmune hepatitis defined the overlap syndrome.

Aim: It was to determine epidemiological, clinic-biological, immunological, histological, therapeutic and evolutive characteristics of PBC and to compare them to those in subjects having an overlap syndrome.

Methods: It is a retrospective study grouping all the cases of PBC hospitalized over a period of 15 years (1995-2009) in the hepatogastro-enterology department at Sahloul hospital in Sousse.

Sclerosing Cholangitis in Behçet's Disease.

Introduction. Sclerosing cholangitis is characterized by an inflammatory and fibrotic lesion of intra- and/or extrahepatic bile ducts. When a causal mechanism of a bile duct lesion is identified, the sclerosing cholangitis is considered secondary.

[Hepatic steatosis in chronic hepatitis B: prevalence, risk factors, and impact on fibrosis and therapeutic response].

Background: steatosis is a common injury in chronic hepatitis C, but this association has not been sufficiently studied in chronic hepatitis B. aim: To evaluate the prevalence of hepatic steatosis in chronic hepatitis B and determine its association with various histologic, biochemical, virological, and metabolic diseases, and its effect on fibrosis and therapeutic response.

Methods: Our study was compiled 133 patients with chronic hepatitis B who received no antiviral therapy and who had a liver biopsy.

The natural history of hepatitis B virus cirrhosis after the first hepatic decompensation in Tunisia.

Aim: To define the natural long term course of viral B cirrhosis after the onset of hepatic decompensation and to determine the predictive factors of death.

Methods: Retrospective longitudinal study including 77 cases of viral B cirrhosis among 192 consecutive patients with cirrhosis, hospitalized between 1997 and 2005 for the first hepatic decompensation. All those patients were followed- up until death or until December 2006.

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.

[Autoimmune hepatitis in Tunisia. Retrospective multicenter study of 83 cases].

Background: Autoimmune hepatitis (AIH) is a chronic inflammatory condition of the liver of unknown etiology. Its epidemiological and anatomoclinical characteristics and its outcome were unknown in Tunisia.

Aim: To analyse epidemiological, anatomoclinical, immunological and histological aspects of AIH and to determine factors predicting relapse after treatment and death of this disease in Tunisia.

[The particularity of Helicobacter pylori chronic gastritis in the west center of Tunisia].

Background: The Helicobacter pylori (HP) is strongly associated with chronic gastritis. The aim of our study was to determine prevalence of the HP chronic gastritis in the west center of Tunisia and to clarify the clinical and the histological particularities of this infection.

Methods: it is a prospectif study carried out from September 2002 to July 2005 and had included 352 patients.

[Immunological profile of coeliac disease in a subgroup of patients with symptoms of irritable bowel syndrome].

Aim: The purpose of this study was to determine if authentic cases of irritable bowel syndrome could be secondary in a latent or potential coeliac disease.

Methods: All new patients who consulted for irritable bowel syndrome fulfilling Rome II criteria between 01/04/2003 and 30/03/2004 were included. All patients had upper endoscopy with duodenal biopsy and colonoscopy or enema.

[Crohn's disease: influence of age at diagnosis on clinical type of disease].

Unlabelled: The aim of the study was to examine the influence of age at diagnosis of Crohn's disease on disease site and course in Tunisian patients.

Methods: All hospital patients for Crohn's disease between 1993 and 2002 were included. They were segregated by age at diagnosis as follows: younger than 20 years, 20-39 years, and 40 years or older.