Hepatomegaly was noted in a 63-year-old man who presented with an exacerbation of chronic pulmonary disease. A diagnosis of hepatic leiomyosarcoma was made by fine needle aspiration biopsy. Intensive investigations failed to reveal a primary source. The patient was treated conservatively.
Two patients are reported who presented with symptoms characteristic of a pancreatic vipoma. The necessity to measure more than one plasma VIP level for diagnosis, and the delay between the onset of illness and diagnosis is illustrated by both cases. Evidence suggests that vipomas are still under reported. The evolution of sophisticated diagnostic and therapeutic modalities over the twenty-five years separating both presentations is discussed.
Both clinicians gave the same rating of activity in 81% (157) of assessments. A good relationship was observed between the median indical values and the clinical gradings for all four indices. The best relationship was demonstrated with the AI with no overlap in 50% values with increasing grades of disease activity. All four indices demonstrated a good correlation with each other (p < 0.01). The best correlation was observed between more objective indices the AI and the Fielding index (r = 0.79) for first assessments only. Conclusion. The Van Hees AI is a reliable measure of inflammatory activity in Crohn's disease and would be useful in multicentre therapeutic trials.
Colonoscopy, a useful diagnostic tool in inflammatory bowel disease, is very accurate in detecting disease and assessing disease extent in Crohn's disease. Despite their accuracy, colonoscopic findings have not been routinely used in the objective follow-up of patients with Crohn's disease. The GETAID (Groupe d'études theraputic des affections inflammatoire du tube digestif) group has shown that following an intensive training period, endoscopists can describe colonoscopic findings in a reproducible manner. However, these descriptions poorly correlate both with clinical or laboratory indexes, and with short or medium term prognosis following prednisolone therapy.
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