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.

Exploring work productivity loss in patients with inflammatory bowel disease.

Aim: We aimed in this study to evaluate the impact of inflammatory bowel disease (IBD) on patients' professional life and to determine predictors of severe work productivity loss (WPL).

Materials & Methods: A cross sectional study including patients with a confirmed diagnosis of IBD. Work productivity was evaluated with the work productivity and activity impairment score.

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.

[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.

Duodenal adenocarcinoma presenting as a mass with aneurismal dilatation.

Duodenal adenocarcinoma is frequent. Aneurysmal dilatation of the small bowel is reported to be a lymphoma characteristic imaging finding. A 57-year-old male was found to have a duodenal adenocarcinoma with aneurismal dilatation on imaging which is an exceptional feature.

Severe hemorrhagic colitis in a patient with chronic myeloid leukemia in the blastic phase after dasatinib use.

Dasatinib is a second-line tyrosine kinase inhibitor used in patients with imatinib resistant or intolerant chronic myeloid leukemia (CML) and Philadelphia chromosome-positive acute leukemia. Gastrointestinal bleeding may occur in up to 7% of patients using dasatinib, although, severe dasatinib-related acute colitis had rarely been reported. Here, we present the case of a 36-year-old female who progressed to acute myeloid leukemia after fourteen months of receiving imatinib for CML in the chronic phase and was treated with a dasatinib-containing chemotherapy regimen.

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.

[Predictive factors of intestinal stenosis in Crohn's disease].

Unlabelled: The aim of our study was to determine demographic, clinical, biological or endoscopic factors that predict intestinal stenosis in Crohn's disease.

Patients And Methods: One hundred and twenty one patients were retrospectively analyzed during 10 years. The diagnosis of stenosis were determined by morphologic and endoscopic exams independently of appearance of symptoms.

[Renal amyloidosis complicating Crohn's disease: report of two cases and review of literature].

Secondary amyloidosis is caused by the extracellular store of the fragment AA of the circulatory protein in serum amyloid-A. It can complicate diseases such as family mediterranean fever, rheumatoid arthritis or Crohn's disease. Renal amyloidosis is a rare but serious complication of Crohn's disease.

[Importance of vaccination chronic hepatitis B].

Weak therapeutic responses and weak immune cytotoxic CD8 and CD4 response in chronic hepatitis B emphasize the necessity to find new therapeutic strategies especially as specific immunotherapy. Vaccination, whose principle was to widen immune repertoire, was used as a curative treatment of chronic hepatitis B. It would be the therapeutic procedure with the lowest cost and the potentially greatest benefit.

[Biliary attacks of surgery of the liver hydatid cyst].

The goal of this work was to describe secondary biliary attacks due to liver hydatid cyst surgery and see their different physiopathological mechanisms again. We report three cases of secondary sclerosing cholangitis. There were three women aged 20, 40 and 60 years, respectively.