Ileo-caecal actinomycosis: report of a case simulating complicated inflammatory bowel disease.

in Acta Gastro-Enterologica Belgica (2001), 64(4), 318-20

Abdominal actinomycosis is a rare infectious disease caused by Actinomyces israelii, a gram-positive anaerobic saprophyte germ that is a normal inhabitant of the upper intestinal tract in humans ... [more ▼]

Abdominal actinomycosis is a rare infectious disease caused by Actinomyces israelii, a gram-positive anaerobic saprophyte germ that is a normal inhabitant of the upper intestinal tract in humans. Actinomyces israelii rarely cause abdominal infections or actinomycosis. Abdominal actinomysosis is characterised by fistulae and abscesses and may mimic cancer or inflammatory bowel disease. Abdominal actinomycosis is difficult to diagnose preoperatively, and often require surgical removal of the diseased tissue, allowing pathologists for giving the definitive diagnosis, revealed by characteristic "sulfur granules". The authors report herein the case of a 47-year-old man who presented with diarrhoea and abdominal pain. Abdominal computed tomography evoked complicated inflammatory bowel disease and surgical procedure was decided. Laparoscopic exploration did not provide further significant information, and laparotomy with diseased bowel resection was performed. Pathology demonstrated "sulfur granules" and allowed the diagnosis of abdominal actinomycosis. This case demonstrated that abdominal actinomycosis should be included in the differential diagnosis when computed tomography shows an infiltrative and inflammatory mass. [less ▲]

Surgical management of hepatic cystic echinococcosis

in Acta Gastro-Enterologica Belgica (1999, January), 62(1), 64

Management of Fulminant Hepatic Failure

in Acta Chirurgica Belgica (1998), 98(6), 235-40

Fulminant hepatic failure is an infrequent but dreadful disease, occurring usually in young patients. Despite fulminant hepatic failure is reversible in most of the cases, some patients develop brain ... [more ▼]

Fulminant hepatic failure is an infrequent but dreadful disease, occurring usually in young patients. Despite fulminant hepatic failure is reversible in most of the cases, some patients develop brain edema and intracranial hypertension, which are the most common cause of death in these patients. Liver transplantation significantly improves the prognosis of selected patients in who precise criteria predict a low chance of survival. This review summarizes the modern standard of care of patients with fulminant hepatic failure, with particular underlining of the management of brain oedema and intracranial hypertension. [less ▲]

Le cas clinique du mois. Sclérose hepato-portale chez un patient traité par azathioprine

in Revue Médicale de Liège (1998), 53(8), 450-453

We report a case of hepatoportal sclerosis in a renal transplant patient treated with azathioprine. The initial symptom was ascites. On the biochemical level, there were cholestasis without cytolysis or ... [more ▼]

We report a case of hepatoportal sclerosis in a renal transplant patient treated with azathioprine. The initial symptom was ascites. On the biochemical level, there were cholestasis without cytolysis or hepatocellular insufficiency. A presinusoidal portal hypertension was found on haemodynamic studies, without portal thrombosis at CT-scan. A diagnosis of hepatoportal sclerosis was evoked on histology and attributed to azathioprine. This case gives an illustration of a classical albeit rare complication of azathioprine. The indolent pattern of the disease and the risk of variceal bleeding point out the need for a hepatic follow-up during the treatment. [less ▲]

Successful Tricuspid Valve Replacement and Pulmonary Valvulotomy for Carcinoid Heart Disease

in Acta Chirurgica Belgica (1996), 96(4), 170-6

A case of successful tricuspid valve replacement with a mechanical prosthesis and pulmonary valvulotomy for carcinoid heart disease is reported. The patient was a 61 years old women. The primary tumor was ... [more ▼]

A case of successful tricuspid valve replacement with a mechanical prosthesis and pulmonary valvulotomy for carcinoid heart disease is reported. The patient was a 61 years old women. The primary tumor was in the terminal ileum. Liver metastasis and carcinoid syndrome were present since 8 years. After cardiac surgery, the patient survived 38 months and late death was related to disseminated metastasis. Even in case of metastasis, carcinoid tumor is slow growing. Without cardiac operation for correction of valvular lesions, terminal symptoms and death may often be related to cardiac operation for correction of valvular lesions, terminal symptoms and death may often be related to cardiac failure rather than to tumoral growth. Thus, even in presence of metastasis, cardiac surgery may be mandatory to improve both quality of life and survival. [less ▲]

Approche thérapeutique du cancer épithélial de l'ovaire au CHU Sart Tilman : Conclusions de la réunion interdisciplinaire du 22 mars 1995

in Revue Médicale de Liège (1995), 50

Notre but est de définir une approche multidisciplinaire permettant d'offrir les meilleures chances de guérison ou de survie prolongée aux patientes. Nous nous sommes basés sur notre expérience ... [more ▼]

Notre but est de définir une approche multidisciplinaire permettant d'offrir les meilleures chances de guérison ou de survie prolongée aux patientes. Nous nous sommes basés sur notre expérience personnelle et les données actuelles de la littérature, tout en intégrant les approches innovatrices (ex : chimiothérapie intrapéritonéale précoce). Pour certaines patientes, le pronostic reste trop sombre avec un traitement standard et il nous semble important de leur proposer un traitement potentiellement plus efficace. [less ▲]

Misdiagnosed Malignancy in Transplanted Organs

in Transplant International (1993), 6(1), 50-4

The case reports of three patients who received cancer-bearing organs at this institution are presented. A fourth recipient, who was to be transplanted with a cancerous kidney, was spared this disastrous ... [more ▼]

The case reports of three patients who received cancer-bearing organs at this institution are presented. A fourth recipient, who was to be transplanted with a cancerous kidney, was spared this disastrous complication. The relevant data regarding the donors is also alluded to, with special reference to the type and site of the primary malignancy. Following these case reports, the implications of these issues, their possible prevention, and further management are discussed. [less ▲]

Chronic Ischaemic Gastritis: An Unusual Form of Splanchnic Vascular Insufficiency

in Journal of Cardiovascular Surgery (The) (1992), 33(4), 451-3

Three cases of erosive gastroduodenitis secondary to chronic splanchnic vascular insufficiency are reported. In all cases, pain failed to respond to conventional therapeutic measures for peptic ulcer ... [more ▼]

Three cases of erosive gastroduodenitis secondary to chronic splanchnic vascular insufficiency are reported. In all cases, pain failed to respond to conventional therapeutic measures for peptic ulcer disease. A patchy discolouration and erythematous mottling of the gastric mucosa, with scattered shallow aphthous ulcers, was seen on endoscopic examination. Angiography showed coeliac axis involvement in all patients, with insufficient mesenteric collateral pathways. Chronic gastritis resolved clinically and endoscopically after revascularization. [less ▲]

Metabolic and respiratory changes after cholecystectomy performed via laparotomy or laparoscopy.

in British Journal of Anaesthesia (1992), 69(4), 341-5

We have compared metabolic and respiratory changes after laparoscopic cholecystectomy (n = 15) with those after open cholecystectomy (n = 15). The durations of postoperative i.v. therapy, fasting and ... [more ▼]

We have compared metabolic and respiratory changes after laparoscopic cholecystectomy (n = 15) with those after open cholecystectomy (n = 15). The durations of postoperative i.v. therapy, fasting and hospital stay were significantly shorter in the laparoscopy group. During the first and second days after operation, analgesic consumption but not pain scores (visual analogue scale) were significantly smaller after laparoscopy, while vital capacity, forced expiratory volume in 1 s, and PaO2 were significantly greater. The metabolic and acute phase responses (glucose, leucocytosis, C-reactive protein) were less after laparoscopy compared with laparotomy. Although plasma cortisol and catecholamine concentrations were not significantly different between the two groups, after surgery interleukin-6 concentrations were less in the laparoscopy group. [less ▲]

Intérêts et limites du bypass de l'ileon distal dans le traitement de l'hypercholestérolémie

in Journal de Chirurgie (1990), 127(2), 76-82

Partial ileal bypass (PIB) was performed in 8 young adults (5 males and 3 females, mean age 37 +/- 5 years) with a history of vascular surgery (aorto-coronary bypass, ACB, n = 6; stroke, n = 2 ... [more ▼]

Partial ileal bypass (PIB) was performed in 8 young adults (5 males and 3 females, mean age 37 +/- 5 years) with a history of vascular surgery (aorto-coronary bypass, ACB, n = 6; stroke, n = 2), presenting with hyperlipidemia (II B: n = 7; IIA: n = 1). None of the patients had diabetes, 2 had mild hypertension, and all were cigarette smokers. Hypolipidemic drugs were discontinued prior to PIB. Following bypass surgery, patients received vitamin B12 injections twice monthly. Total plasma cholesterol (TPC) and total plasma triglycerides (TPT) were assayed at 3 months and 1 year after surgery. The mean follow-up period was 84 months. Mean TPC level was significantly lower (3.96 +/- 0.57 preoperatively vs 2.19 +/- 0.79 (p less than 0.001) and 2.54 +/- 0.76 (p less than 0.01) 3 months and 1 year postsurgery, respectively. Mean TPT level was significantly lower 3 months after the intervention (4.85 +/- 2.37 vs 2.33 +/- 0.62, p. less than 0.02), but not after one year. Similar trends were observed throughout the follow-up period. One of the ACB patients died of drowing, while three others had recurring angina pectoris symptoms. Coronary angiography showed that, despite low TPC levels, coronary artery disease had extended either to other vessels not included in the former bypass, or beyond the anastomoses. Patients with a history of stroke were asymptomatic. PIB is effective in normalizing TPC. Nonetheless, this isolated procedure is insufficient to prevent the evolution of multifactorial atherosclerosis. [less ▲]