[Impact of endoscopy in Crohn's disease].

Two types of endoscopic lesions are observed in Crohn's disease (CD): active lesions or scars, frequently associated. Following their localization at different sites of the digestive tract, they are defining the type of disease. Ileo-colonoscopy is an important step of the initial characterization of the lesions, completed with biopsies helful for the differential diagnosis between CD and ulcerative colitis or infectious colitis An endoscopy is only repeated in front of a new clinical problem or when a change of treatment is required.

Interaction between azathioprine and aminosalicylates: an in vivo study in patients with Crohn's disease.

Background: The inhibition of thiopurine methyltransferase activity, one of the enzymes responsible for azathioprine metabolism, by aminosalicylates has been described in an in vitro study. This could result in a higher risk of bone marrow depression when using the two drugs together.

Aim: To investigate the in vivo interaction between azathioprine and aminosalicylates in quiescent Crohn's disease by measuring 6-thioguanine nucleotide levels, thiopurine methyltransferase activity and the plasma levels of the acetylated metabolite of 5-aminosalicylic acid.

Perianal condylomata acuminata.

Anal and perianal condylomata acuminata are warts caused by infection with the human papillomavirus (HPV). The annual incidence of genital warts seems to have increased during the past few decades. Approximately 1.

[Hemorrhoids. Review].

Correct definition of haemorrhoidal disease allows the estimation of the incidence and the therapeutic choices. The term "haemorrhoidal disease" should be used specifically for symptoms secondary to abnormalities of the intern haemorrhoidal plexus. The classification of severity is useful but difficult to apply to individual cases.

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.

Assessment of the new immunological test Hemoblot for detecting occult blood in faeces.

Hemoblot, a new immunological faecal occult blood test, produced by Gamma, Angleur, Belgium, was characterized and compared with another immunological test (HemeSelect, SmithKline Diagnostics, USA) and with a guaiac test (Hemoccult II, SmithKline Diagnostics). The analytical sensitivity of Hemoblot is 0.15 mg haemoglobin/g faeces and the test is specific for human haemoglobin.

[Ileo-anal anastomosis in hemorrhagic-ulcerative rectocolitis and familial adenomatous polyposis: is it mandatory to perform resection of the endo-anal mucosa?].

The aim of this study was to assess the clinical outcome after ileal pouch-anal anastomosis with mucosectomy for ulcerative colitis and for familial adenomatous polyposis, and to characterize the histology of the stripped endoanal mucosa with particular reference to the ulcerative colitis activity, adenomatous polyps and dysplasia. Twenty-eight patients were operated, 16 for ulcerative colitis (group I) and 12 for familial adenomatous polyposis (group II). In group I, there were no intraoperative complications, but mucosectomy was tedious in 10 patients (62%) and the anastomosis was performed under some degree of tension in 10 patients (62%).

[Anal surgery in Crohn disease].

For twenty years, opinions concerning local surgery of anal lesions in Crohn's disease have changed in practice and in the literature. We have reviewed 209 patients, usually in remission of disease, with at least 6 months' follow-up, who underwent local surgery for various anal lesions from 1974 to 1992. In this study, our indications and results are discussed and compared to the literature.

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.

[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.

Coombs-positive autoimmune hemolytic anemia complicating ulcerative colitis. A case report.

We report the case of a 41-year-old woman with a 5-year history of left-sided ulcerative colitis easily controlled by sulfasalazine. She was admitted because of severe anemia, in the absence of any exacerbation of the colitis. A Coombs-positive (IgG type) hemolytic anemia was diagnosed and high-dose corticosteroid therapy was started, which proved to be unsuccessful.

Chronic idiopathic constipation with outlet obstruction.

Defecatory difficulties may be a source of great distress to patients. Normal defecation requires the coordination of abdominal and pelvic muscles. Throughout the last decade, many studies have demonstrated various and often mixed abnormalities of these mechanisms.

[Etiopathogenesis of colonic diverticular disease; role of dietary fiber and therapeutic perspectives].

The authors review the literature about the aetiopathogenesis, the epidemiology and the treatment of uncomplicated diverticular disease of the colon. The influence of dietary fibre deficiency explaining the increasing prevalence in industrialized countries and the variable geographical distribution are explained, as well as the effects of dietary fibres on colonic functions. Progressive elastosis of the taeniae may explain the influence of age on the incidence of diverticulosis.

Colonic angiodysplasia. Follow-up of patients after endoscopic treatment for bleeding lesions.

Endoscopic electrocoagulation or photocoagulation is now the method of choice for treating colonic angiodysplasia. Follow-up of such patients has not been extensive. The authors report 26 patients with typical and symptomatic lesions who have been treated endoscopically.

[Villous tumors of the rectum. Endoscopic treatment using photocoagulation].

We report the results of endoscopic photocoagulation in the treatment of villous adenomas of the rectum in 49 consecutive patients (26 males, and 23 females, mean age: 74 years). Twenty-six patients were treated with a high-power Nd-Yag laser (80 W/sec). After a mean of 3.

[Villous tumors of the rectum. Endoscopic treatment using monopolar coagulation].

Unlabelled: Many methods are used to treat villous adenomas of the rectum. The best choice between these methods is not well established. Ninety-six patients (47 men, 49 women) treated with endoscopic monopolar coagulation were studied.

[Risk of recurrence of colorectal polyps following endoscopic resection].

From 1976 to 1985, 1063 patients (614 men, 449 women, mean age: 63 years) underwent the excision of 1887 adenomatous or villous colonic or rectal polyps. Regular controls by barium enema or total colonoscopy have been proposed to these patients. A first control, performed in 715 patients (67%) after a mean of 27 months, revealed the presence of polyps in 162 of them (23%).

[Solitary lesions of the rectum caused by suppositories combining acetylsalicylic acid and paracetamol].

The reports of 8 female patients who, because of recurrent headache, were using analgesic suppositories containing acetylsalicylic acid and paracetamol (Perdolan) for more than two years are analyzed. Symptoms were nonspecific: anal pain, rectal tenesmus or bleeding. The lesions were located within 8 cm from the anal verge and consisted of superficial ulcerations, fibrotic scar tissue and rectal stenosis.

[Anal surgery in Crohn's disease. Clinical and functional results].

The aim of this study was to evaluate the results of anal surgery performed in 105 patients for perianal symptomatic complications of Crohn's disease. The patients were divided into 3 groups: group I: 45 patients with simple fistulae; group II: 53 patients with complex fistulae; group III: 7 patients with other symptomatic perianal lesions. All patients underwent a resection of their perianal lesions.