Introduction: Celiac disease is an autoimmune enteropathy induced by the ingestion of gluten (wheat, barley, rye). The classical form has become a minority. Currently, the most frequent forms of presentation are extraintestinal with various manifestations, among others, reproductive disorders. The aim of our study is to assess the frequency of these disorders in celiac disease and their evolution under gluten-free diet.
Introduction: Low-dose Aspirin is widely used for the prevention of cardiovascular events, but despite its beneficial effects, it can generate more or less serious digestive disorders. The aim of this study was to evaluate endoscopically by the Lanza score the gastroduodenal lesions in patients on long-term low-dose aspirin with upper gastrointestinal bleeding (UGB). Materials and Methods: A five years long prospective, descriptive study recruiting from the UGB patients admitted successively to the emergency department of a university hospital, those who were taking long-term low-dose aspirin (75-325mg/day). Eligible patients were those with UGB (hematemesis or melena) who had an esophagogastroduodenoscopy (OGD) within 24 hours following the bleeding. Results: Among 2135 cases of UGB admitted to emergency departments in the same period; 134 cases (6.3%) occurred in patients with low-dose aspirin with average age: 65.3 ± 24.7 years and sex ratio: 2.3 F / M. Hypertensive heart disease is noted in 123/134 (91.8%), Tobacco use in 32/134 (23.9%), alcohol in 28/134 (20.9%), concomitant NSAID therapy in 10/134 (7.5%), Anticoagulant in 20/134 (15%), and a history of peptic ulcer in 17/134 (12.7%). The UGB was severe in 73/134 (54.5%) and required blood transfusion in 89/134 (66.4%). At endoscopic examination: bulbar ulcer in 44/134 (32.9%), antral ulcer in 39/134 (29%) and erosive Bulbar duodenitis in 29/134 (21.6%). Stages 3 and 4 of the Lanza classification were observed in 95/134 (71%). All patients received anti-secretory medical treatment, endoscopic sclerosis was required in 6/134 (4.5%) and surgery in 3/134 (2.2%). Conclusion: In this work, women over 65 are the most concerned. Bulbar and antral ulcers are the most frequent lesions, and stages 3 and 4 are the most frequent of the Lanza score, these are evidence of the seriousness of the lesions caused by the long-term low-dose aspirin.
The post-surgical anastomotic oesophageal stenosis is usually benign, which may recur rapidly after several endoscopic dilations (refractory stenosis). The purpose of this work is to show, through an observation, the interest of the injection of the corticoids during the endoscopic treatment of refractory oesophageal stenosis. It was a patient who benefited from an esophagectomy of 2/3 inferior+oeso-gastric anastomosis after ingestion of hydrochloric acid (spirit of salt).The evolution was marked by the installation of a post-anastomotic stenosis recurring after several sessions of endoscopic dilations. The local injection of the corticosteroids (Triamcinolone) at the time of the dilation sessions, allowed a decrease in the frequency of the dilatations, a disappearance of the dysphagia, an improvement of the general state with a weight gain. The injection of corticosteroids was a good solution for this patient, to avoid endoscopic treatment failures, and to improve her quality of life.
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