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Biomedical subjects

A Bergue

Publications and source records attributed to A Bergue.

At least 19 recordsLinked to original sources
PubMed1996

[Prolonged clinical remission of cholangitis in early human immunodeficiency virus infection after surgical biliary derivation].

During the acquired immunodeficiency syndrome, most cases of cholangitis develop at an advanced stage of disease. We report a case of cholangitis in a 47-year-old homosexual man, stage IIa according to Center of Disease Control classification. An isolated jaundice was the first manifestation of the disease. The number of CD4 was 380/microL. Ultrasonography and endoscopic retrograde cholangiography showed a 7 cm stenosis of the common bile duct, and cystic duct stenosis, with associated intra-hepatic biliary duct dilatation. No infectious agent was found. Cholecystectomy and hepaticojejunostomy were performed. Pathological examination of liver biopsy and a sample of the resected common bile duct was consistent with sclerosing cholangitis. The postoperative course was uneventful. During a three year follow-up period, the patient was disease free but he suddenly died of uncontrolled bleeding from duodenal ulcer. In HIV-infected patients, surgical treatment can be performed in case of symptomatic long stenosis of the common bile duct.

Biliary Tract Surgical Procedures↗
PubMed1995

Small intestinal stricture complicating superior mesenteric vein thrombosis. A study of three cases.

Mesenteric vein thrombosis associated with intestinal stricture, as a consequence of intestinal ischaemia, has only been mentioned twice in published works. The clinical, biological, and morphological aspects as well as the treatment of this morbid association were studied in three patients. In all, a two stage clinical course (initial acute abdominal pain and fever, followed by chronic intestinal obstruction), corresponding to the sequence thrombosis/stricture, was found. x Ray studies showed a regularly contoured intestinal stricture. Surgical resection was required in all three cases for stricture, associated in one case with mesenteric infarction. Anticoagulation treatment was used to preclude recurrence. Increased clinical awareness could lead to the diagnosis of intestinal stricture secondary to mesenteric vein thrombosis more often and at an earlier stage. Treatment consists of evaluation of predisposing features, intestinal resection when necessary, and anticoagulation therapy, as indicated.

Adult↗
PubMed1995

[Diagnostic efficiency of histological and simple microbiological tests for Helicobacter pylori detection in a community hospital].

The objective of this study was to compare histology and microbiology (direct method, urease test, culture) for the detection of Helicobacter pylori in antral biopsies. Thirty-six patients, aged between 18 and 82, with a peptic ulcer (active or not), or gastritis or duodenitis were studied. Eighteen patients (50%) had a positive culture, 17 (47%) had a positive urease test, 16 (41%) had positive direct microbiology and 15 (42%) had positive histology. Correlation between histology and culture was 84%. This study confirms the good sensitivity of histology and the urease test for the detection of Helicobacter pylori. Combination of both methods could optimise detection of the organism.

Adolescent↗
PubMed1993

[Autoimmune dysthyroidism induced by alpha interferon in two female patients with chronic non-A, non-B hepatitis].

We report two cases of autoimmune thyroid disorders which appeared after 6 months of recombinant alpha interferon therapy given for chronic non-A, non-B hepatitis. There was no family or personal history of thyroid disease, or had the patients taken any hepatic or thyroid toxic drugs. The other causes of hepatic and thyroid diseases were ruled out. The first case concerned a 33-year-old woman with sporadic hepatitis C. Therapy was complicated by the appearance of antimicrosomal thyroid antibodies and hypothyroidism. At 22 months, substitutive therapy was still necessary in one case. The second case involved a 37-year-old woman with post-transfusional non-A, non-B hepatitis which was complicated by transient hypothyroidism preceding thyrotoxicosis (with TSH-receptor antibodies). We observed a return to euthyroidism and loss of associated antibodies after withdrawal of interferon and institution of hormonal therapy.

Adult↗
PubMed1991

[Benign mucus-secreting tumors of the appendix. Six cases].

The authors report six cases of mucus-secreting tumor of the vermicular appendix, in four women and two men (mean age 59 years). All were benign. Pain in the right lower quadrant was the initial sign in 4 cases, while the mucus-secreting tumor was an incidental finding in the other two cases. A mass was palpated in the right lower quadrant in one case. A barium enema was performed in four cases and showed an extrinsic compression of the caecal base in one case, and of the right colon in another case. Four appendectomies, one associated with removal of the adjacent caecal tissues and two right colectomies were performed. Analysis of these six cases and a review of the literature allow us to recall the histologic classification of these tumors, which determines the prognosis and to emphasize the sonographic and CT scan findings which might lead to earlier preoperative diagnosis in the future. Management depends upon the circumstances under which the tumor is discovered, the local anatomy, and the type of tumor. Appendectomy is the treatment most often performed. Faced with a tumor of the appendix, without histologic proof or when the local anatomic conditions increase the risk of opening an abscess, right colectomy is recommended.

Aged↗
PubMed1991

[Solitary eosinophilic granuloma of the external wall of the orbit].

Eosinophilic granuloma is a solitary form of histiocytosis X with a usually good prognosis. Sometimes spontaneous healing can even occur. The authors report a case of a 30-month-old boy who presented an eosinophilic granuloma of the lateral orbital wall. The correct diagnosis was obtained after computed tomographic scan followed by fine needle aspiration biopsy with histopathologic examination. The tumor increased rapidly, including a medial displacement of the globe and limitation of the eye movement. So chemotherapy (Vinblastine) with corticotherapy was performed. The clinical course was favorable, with no evidence of recurrence or systemic involvement. The originality of this case was the young age of the patient, the course and the efficacy of treatment. The authors emphasize the management of the disease.

Child, Preschool↗
PubMed1990

Acute pancreatitis associated with non-A-non-B hepatitis. Report of a case.

A 33-year-old man, vaccinated against hepatitis B virus, working in an hemodialysis unit, pricked himself with a needle used in a patient. Four weeks later he developed acute hepatitis along with acute pancreatitis. The pancreatitis resolved, but the liver disease ran a chronic course. The diagnosis of hepatitis non-A-non-B (NANB) was made on the following criteria: (a) epidemiologic circumstances, (b) exclusion of other causes of acute and/or chronic liver disease, (c) chronic indolent course, and (d) compatible histological features. The diagnosis of acute pancreatitis was made with clinical, biological, and radiological data. We believe that the pancreatitis was related to the NANB viral infection, as they began simultaneously and other causes of pancreatitis were eliminated. Such an association has been reported mainly with hepatitis B and exceptionally with hepatitis A. It has also been observed in the course of fulminant NANB viral hepatitis, but we believe this to be the first case associated with a benign form of NANB.

Acute Disease↗
PubMed1990

[Invalidating polyarthritis in chronic pancreatitis. Recovery by pancreaticojejunostomy].

A 38 year-old man presented with migratory joint arthropathy. He complained of abdominal pain, diarrhea and weight loss for 2 years. Periarticular needle aspiration yielded cytosteatonecrosis. The diagnosis of chronic pancreatitis was based on the results of ultrasound, CT scan, and endoscopic retrograde pancreatography. The latter showed a dilated and moniliform main pancreatic duct. Failure of symptomatic medical treatment of arthritis led to perform pancreaticojejunostomy which was followed immediately by complete relief of arthritic symptoms. During pancreatic disease, whether malignant or benign, joint involvement is often associated with bone, cutaneous, serosal, and multiorgan involvement. The pathogenesis and therapy of joint lesions in pancreatic disease are controversed. Surgical treatment of the causative disease, and especially pancreaticojejunostomy should undoubtedly be considered more often.

Adult↗
PubMed1984

[Icterus disclosing pancreatic involvement in idiopathic hypereosinophilic syndrome].

We report herein what we think is the first case of an idiopathic hypereosinophilic syndrome in which jaundice (caused by eosinophilic pancreatitis) was the first major symptom. The duodenum and an antral polyp were also infiltrated by eosinophils. In our case, diagnosis was based upon the classic three fold criteria: a) persistent eosinophilia (greater than or equal to 1,500/mm3, b) lack of evidence for any other recognized cause of eosinophilia, c) multiple organ systemic involvement: skin, lymph nodes, heart (detected by routine echocardiography), nerves (discovered on electromyography), and later, arthritis and pleural effusion. Biological signs included increased plasmatic IgE levels (3,500 UI/ml), circulating immune complexes and absence of leukemic markers. This case emphasizes the difficulty in classifying eosinophilic infiltrations of the gut and the possibility of transitional forms between eosinophilic granuloma, eosinophilic gastroenteritis and the hypereosinophilic syndrome.

Adult↗
PubMed1984

Cavitation of mesenteric lymph nodes, splenic atrophy, and a flat small intestinal mucosa. Report of six cases.

This study describes, in 6 patients with a flat small intestinal mucosa and splenic atrophy, a particular lesion of the mesenteric lymph nodes termed "cavitation." In 4 women and 2 men with abdominal mass, intestinal obstruction, or suspected celiac disease-associated lymphoma, unusual pseudocystic lymph node lesions were found in the jejunal or jejunoileal mesentery. These lesions consisted histologically of a large central cavity occupied by hyaline-type material and surrounded by fibrous tissue and remnants of lymph node structures. There was no histologic evidence of malignant lymphoma or mesenteric panniculitis. Diffuse subtotal villous atrophy involving at least the jejunum was found in each case, together with unequivocal biological and morphological evidence of splenic atrophy, severe malabsorption, and a history of chronic or childhood diarrhea. HLA B8 or DR3, or both, was present in 4 of 4 cases; dermatitis herpetiformis was present in 1 case. An unequivocal mucosal response to a gluten-free diet was observed in 2 cases. Four patients died of cachexia or hyposplenism-related infections. We conclude that cavitation of mesenteric lymph nodes is an original feature which may be associated with splenic atrophy and a flat small intestinal mucosa; some of these patients may have celiac disease. Pathogenesis is unknown.

Adult↗
PubMed1983

[Gastric eosinophilic granuloma : value of endoscopic polypectomy. Apropos of 2 cases].

Two ulcerated, sessile, gastric eosinophilic granulomas, measuring 5 and 10 mm in diameter, were diagnosed by endoscopic polypectomy (accurate prior forceps biopsy had not established accurate diagnosis). The patients, aged 76 and 74 years, had anemia and epigastric pain respectively. None of the usual etiologies (parasitic, chemical, traumatic and ulcerous) were found. Survival, clinical symptoms and location were similar to data reported in the literature, which are briefly reviewed. The value of endoscopic polypectomy is emphasized. With this procedure, pedunculated forms can be treated and sessile forms diagnosed, thus avoiding a useless gastrectomy and its hazards in these elderly patients.

Aged↗