Isolated gastric outlet obstruction after 1 month of asymptomatic ingestion of corrosive is a rare phenomenon and rarely reported. In this type of cases, diagnosis is very difficult due to no symptoms at the time of poisoning, and biased history. We report a case of a young male presented with isolated gastric outlet obstruction after 1 month of asymptomatic ingestion of toilet cleaner, which was known to us later, mimicking linitis plastica. On upper endoscopy, the stomach was grossly edematous, antrum edematous and inflamed with reduced distensibility and narrow pyloric canal. Endoscopic ultrasound of the stomach revealed diffuse thickening of the gastric wall, mainly the antrum, involving submucosa and muscularis propria. We propose corrosive injury to be in the differential diagnosis of gastric linitis plastica.
Human schistosomiasis is one of the most harmful parasitic diseases. It is reported to be endemic in 77 countries in tropical and subtropical regions, leading to infection of about 250 million individuals universal 1 . Schistos-omiasis is a disease caused predominantly by the host's immune response to schistosoma ova and the granulomatous reaction they induce 1-6 . The granulomas destroy the eggs and sequester or neutralize otherwise pathogenic egg antigens
Background. Spontaneous bacterial peritonitis (SBP) is a fatal complication of liver cirrhosis with high mortality rates. Objective: The aim of this study is to investigate the diagnostic utility of absolute neutrophil count (ANC) as a non-invasive marker for SBP diagnosis. Methods. Six hundred patients with cirrhotic ascites were included in the study. All patients underwent abdominal paracentesis and the ascitic fluid was processed for cell count and culture. Results. Absolute neutrophil count was significantly higher in SBP versus non-SBP and in culture positive SBP versus culture negative SBP. ANC at cutoff value > 2.804 has 84% sensitivity and 78% specificity for diagnosis of SBP with positive and negative predictive values (79.4% and 83.6 respectively). At a cut-off point > 5.6, ANC is capable of differentiating culture positive SBP from culture negative SBP cases with 62.07% sensitivity and 60.87 % specificity. Increased ANC, WBC, CRP, creatinine and decreased platelet emerged as independent risk factors for SBP development, while increased ANC, WBC and decreased platelets were independent predictors of culture positive SBP. Conclusion. This study demonstrates that, ANC count is simple, non-invasive diagnostic marker for SBP. Increased ANC, WBC, CRP, creatinine and decreased platelet emerged as independent risk factors for SBP development.
Background: Hepatitis C virus (HCV) infection is considered one of the main causes of chronic liver disease around the world. Liver biopsy has been believed to be the gold standard for the assessment of the degree of liver fibrosis. Thus, there is a need to improve non-invasive evaluation of liver fibrosis. The aim of the present study was to study the changes in serum levels of ATX (Autotaxin) as a marker of hepatic fibrosis in responders to HCV treatment by DAAs. This prospective study was carried out at hepatology outpatient clinics for HCV treatment in Mansoura Specialized Medical Hospital that involved 54 participants: 34 patients with HCV and 20 controls; ATX was measured for the controls and all patients before and after treatment. Results: We found a significant higher ATX level in control subjects vs HCV patients, 100% of control subjects had ATX > 97.5 and 58.8% of HCV had ATX ≤ 97.5. Also, a significantly higher ATX after treatment with DAAs as a whole was observed. Conclusion: The authors concluded that ATX should be considered cautiously as a diagnostic marker for liver fibrosis in Egyptian patients with chronic hepatitis C infection. Although this study yielded negative results, this may be important to prevent duplication of the research efforts.
Objective: The aim of this work was to evaluate Multidetector Computed Tomography (MDCT) findings
of hepatic manifestation in common malignant hematological disorders.
Materials and Methods: This retrospective study included 300 patients with different types of malignant
hematological disorders. They were 119 female and 181 male (mean age, 45.4 year; range, 5-70 years). The
most common hematological disorder was Non-Hodgkin lymphoma (NHL) detected in 192/300 (64%)
patients and then Hodgkin disease (HD) detected in 40/300 (13.3%) patients. All 300 patients had
ultrasonography. Clinical evaluation and laboratory assessment were done for all patients. Whole body and
triphasic abdominal CT scanning was performed on 64 MDCT systems.
Results: MDCT scanning revealed hepatic affection in 82/192 of NHL. All these 82 cases revealed
hepatomegaly and focal lesion detected in 36 cases. As regard Hodgkin disease (HD), hepatomegaly
detected in 22/40 cases and focal lesion detected in 8/40 cases. Hepatomegaly detected in 8/14 cases of
acute myeloid leukemia (AML) and focal lesion detected in 4/14 cases. In cases of chronic lymphocytic
leukemia (CLL), hepatomegaly detected in 6/22 cases with no detection of focal lesion.
Conclusion: Hepatic involvement is often observed in several malignant hematological disorders, resulting
in abnormalities in liver imaging studies. Malignant hematological disorders must be considered in
hepatomegaly and hepatic focal lesions either single or multiple. MDCT is the diagnostic modality of choice
for diagnosis and follow up of liver affection in different malignant hematological disorders.
Background: Hepatocellular carcinoma (HCC) is an aggressive deadly cancer with few therapeutic options mostly limited for early-stage HCC. Unfortunately, alphafetoprotein (AFP) has a limited performance, especially in early-stage HCC.
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