Acta gastro-enterologica Belgica
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Acta Gastroenterol. Belg. · Oct 2004
Case ReportsHepatitis caused by occupational chronic exposure to trichloroethylene.
Trichloroethylene (TCE) is an organic solvent used in a variety of industries for more than 60 years. Several adverse events following acute or chronic exposure to trichloroethylene have been reported. However, TCE-induced hepatitis is very rare. ⋯ Workers exposed to hazardous chemicals, such as trichloroethylene, must have periodic follow-up examinations. Good work practices are very important when using toxic substances. In patients whose initial diagnostic workout is negative for common causes of acute or chronic hepatitis, toxic causes should be considered, with emphasis on patient's job and working conditions.
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Acta Gastroenterol. Belg. · Apr 2001
ReviewStrategies targeting tumor necrosis factor in Crohn's disease.
Tumor necrosis factor plays an important role in mediating the inflammation of Crohn's disease. Strategies aimed at reducing tumor necrosis factor in patients with Crohn's disease include the mouse/human chimeric monoclonal antibody infliximab, the humanized monoclonal antibody CDP571, the human recombinant tumor necrosis factor receptor fusion protein etanercept, and the small molecule thalidomide. Infliximab is effective for treating active Crohn's disease, maintaining remission, and closing fistulas. ⋯ Side effects occurring in patients treated with CDP571 include anti-idiotype antibodies, infusion reactions, and formation of autoantibodies. Pilot studies have suggested that etanercept and thalidomide may also be beneficial. Anti-tumor necrosis factor therapies are effective for the treatment for Crohn's disease.
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Acta Gastroenterol. Belg. · Oct 1999
NSAID use and abuse in gastroenterology: refractory peptic ulcers.
With current antiulcer therapies to eliminate H. pylori infection, non-steroidal antiinflammatory drug use is the main factor involved in resistant peptic ulcers which must be defined as those ulcers that do not heal after 6 (duodenal ulcers) or 8 (gastric ulcers) weeks of treatment with proton pump inhibitors, despite H. pylori eradication. NSAID use (especially aspirin abuse) in patients with resistant ulcers is often surreptitious. Ulcers tend to complicate with stenosis and bleeding, commonly change site, are multicentric and have poorly defined margins. ⋯ Refractory ulcers with no evidence of NSAID use and no evidence of H. pylori infection are rare but not exceptional. Smoking and genetic background seem important factors in patients with this type of ulcers. Idiopathic basal gastric acid hypersecretion might be important in a few patients, but the Zollinguer-Ellison syndrome must be ruled out.
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Acta Gastroenterol. Belg. · Jul 1999
Experience with living related liver transplantation in 63 children.
The incentive to develop intrafamilial living related liver transplantation (LRLT) originated from the shortage of cadaveric organ supply. We report our experience with LRLT in 63 children during 1993-1998 in the frame of a protocol approved by the Ethics Committee of our Institution. During this period, 152 potential intrafamilial (mostly parental) donors were evaluated; 44 (28.5%) were excluded because of surgical (n = 4), medical (n = 39) or psychosocial reason (n = 1). ⋯ Biliary complications were observed in 26.9% (bile leak from cut surface in 3.1%, anastomotic stricture in 22.2% and intrahepatic stricture in 1.5%); two patients died from septic shock possibly related to uncompletely relieved anastomotic stricture; all other biliary complications were successfully treated either conservatively or surgically. The incidence of acute rejection was 90.9% in 22 patients with Cyclosporine-based immunosuppression; acute rejection was corticoresistant in 50%. It was 46.3% in 41 patients with Tacrolimus-based immunosuppression (64% with Prograft in capsules and 18.7% with Prograft in granules); no acute rejection was corticoresistant. (ABSTRACT TRUNCATED)
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Acta Gastroenterol. Belg. · Jul 1998
Case ReportsAcute intestinal obstruction caused by endometriosis mimicking sigmoid carcinoma.
Endometriosis is a relatively frequent disease in fertile women. The intestine is involved in 12-37% of cases. ⋯ We report a case of endometriosis of the sigmoid, which caused complete intestinal obstruction and mimicked carcinoma of the sigmoid colon. This case demonstrates the difficulty of establishing an accurate pre- and peroperative diagnosis and the propensity of intestinal endometriosis to mimic colon cancer.