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H Hagege

Publications and source records attributed to H Hagege.

At least 19 recordsLinked to original sources
PubMed2000

[Cystic dystrophy of an aberrant pancreas. Surgery after failure of medical therapy].

BACKGROUND: Cystic dystrophy of aberrant pancreas, characterized by cystic formations in ectopic pancreatic tissue, produces variable signs. Treatment is difficult. CASE REPORT: Our patient presented signs of acute pancreatitis and angiocholitis due to cystic dystrophy of an aberrant pancreas situated in the duodenal wall associated with chronic alcoholic pancreatitis. Prolonged medical treatment was unsuccessful. Duodenopancreatectomy with preservation of the tail led to complete regression of the clinical signs. DISCUSSION: Signs of cystic dystrophy of an aberrant pancreas vary greatly. Diagnosis is generally established on the basis of echoendoscopic findings. After failure of medical treatment, duodenopancreatectomy with preservation of the tail could be the most appropriate surgical treatment, hypothesizing that the disorders result from obstruction of the Wirsung and the lower main bile ducts.

Choristoma↗
PubMed2000

[Unusual cause of severe alveolar hypoventilation].

Mesenteric panniculitis is a rare disease of the adipose tissue of mesentery. Ascites is an unusual presentation. We report a case of panniculitis whose initial presentation was an obesity-hypoventilation syndrome with pulmonary hypertension. Respiratory disorders were related to abundant ascites. Panniculitis cure and ascites disappearance allowed return to normal pulmonary function and pulmonary artery pressure.

Aged↗
PubMed1999

[Ticlopidine-induced lymphocytic colitis].

Lymphocytic colitis is a clinico-pathological syndrome characterized by chronic diarrhea, normal endoscopy, diffuse colonic mucosal inflammatory changes. Collagenous colitis is defined by a thickening of the collagen plate. The etiology is unknown but immune disorders have been frequently associated with it and it has been linked with the taking of certain drugs such as nonsteroïd anti-inflammatory drugs or veinotonics. We are reporting a case of microscopic colitis associating both lymphocytic and collagenous colitis, wich induced chronic diarrhea in a 65-year-old man. It appeared after he had taken ticlopidine. Diarrhea stopped after he had discontinuated ticlopidine, and recurred after he resumed taking the drug. Histological damages from lymphocytic colitis improved six month after he had stopped taking ticlopidine. Chronic diarrhea induced by ticlopidine might be caused by lymphocytic colitis.

Aged↗
PubMed1994

[Psoas abscess exteriorized in the groin revealed late after acute pancreatitis].

Two cases of psoas abscess complicating acute necrotizing pancreatitis are reported. These cases were particular because the abscesses exteriorized in the groin and symptoms were misleading. The abscesses were detected late, three and five months after the beginning of the pancreatitis respectively. The difficulties in diagnosis and the long delay to diagnosis are emphasized as possible sources of superinfection.

Acute Disease↗
PubMed1993

Grand mal seizures as a complication of treatment with pefloxacin in patients with cirrhosis. A report of three cases.

In this paper, three cases of grand mal seizures are reported as a complication of pefloxacin at usual doses (400 mg twice a day) in patients with cirrhosis. Grand mal seizures occurred from 12 h to 8 days after the onset of pefloxacin treatment. In 1 case, seizures recurred after inadvertent rechallenge with the drug. Elevated pefloxacin serum levels were demonstrated in 2 cases. Brain computed tomography in all 3 cases and cerebrospinal fluid examination showed normal results. No etiology other than pefloxacin overdose was found. After pefloxacin withdrawal, no recurrence of seizures were observed. Therefore, when pefloxacin treatment is indicated for cirrhotic patients, a reduced dosage and/or careful monitoring of pefloxacin serum levels should be recommended.

Child↗
PubMed1991

Asymptomatic bacterascites: is it spontaneous bacterial peritonitis?

Asymptomatic bacterascites is defined as the presence of bacteria in ascitic fluid without clinical features of peritonitis or increased ascitic fluid polymorphonuclear cells. Asymptomatic bacterascites is a controversial entity, and little information is available regarding its spontaneous evolution. Clinical features, bacteriological data and outcome in 22 cirrhotic patients with asymptomatic bacterascites are reported and are compared with those of a group of 36 cirrhotic patients with spontaneous bacterial peritonitis. Eleven patients had gram-negative bacteria and 11 had one gram-positive bacteria. Only in three patients (13.6%) did peritonitis develop. Twelve patients received no antibiotic therapy, and in none did peritonitis develop. At 1 month, 27% of patients with asymptomatic bacterascites had died. Patients with asymptomatic bacterascites had less-severe liver disease; they more frequently had gram-positive bacteria in ascitic fluid and had a lower 1-mo mortality rate than did patients with spontaneous bacterial peritonitis. We conclude that asymptomatic bacterascites is usually the transient residence of bacteria in ascitic fluid. Peritonitis rarely develops in patients with asymptomatic bacterascites and, in most of them, antibiotic therapy is not required.

Adult↗
PubMed1991

Pharmacokinetics of metoclopramide in patients with liver cirrhosis.

The pharmacokinetics of metoclopramide were investigated after intravenous and oral administration in eight patients with severe alcoholic cirrhosis and in eight healthy volunteers. As a consequence of a 50% lower clearance (0.16 +/- 0.07 vs 0.34 +/- 0.09 l h-1 kg-1, plasma drug concentrations and the half-life of metoclopramide were greater in patients following both routes of drug administration. Volume of distribution (3.1 +/- 0.8 vs 3.4 +/- 1.2 l kg-1) and absolute bioavailability (79 +/- 19 vs 84 +/- 15%) were similar in the two groups. The adverse effects of metoclopramide observed in patients with marked hepatic impairment are likely to result from increased accumulation of the drug as a result of impaired clearance. Consequently a reduction in dose of 50% is recommended in patients with severe liver cirrhosis.

Administration, Oral↗
PubMed1991

[Long-term outcome of alcoholic patients after a stay in a hospital hepatogastroenterology unit].

The long term results of psychologically oriented treatment for alcoholism were evaluated in 147 patients hospitalized in a liver unit and followed for 1-5 years. Twenty-three percent of the patients were hospitalized for treatment of alcoholism, while 61 percent were hospitalized for alcohol-related disease. The main patient characteristics were: males: 71 percent; age: 48 +/- 10 years (mean +/- SD); alcoholic cirrhosis: 48 percent; initial request for help in abstinence: 9 percent; and unemployment: 35 percent. During the hospitalization (16 +/- 10 days), each patient had 1 to 4 psychotherapeutic interviews. Seventy-four percent of patients responded to follow-up after discharge and contact was maintained in 23 percent of patients 2 years thereafter. The only two independent prognostic variables for long-term follow up were the need for medical supervision (P less than 0.001) and employment (P less than 0.005) (Cox model). Only 10 percent of the patients attended a post-hospitalisation psychotherapeutic program. Among the 108 patients who were followed, 35 percent were totally abstinent immediately after discharge and 17 percent did not relapse during the 2 following years. Relapse was unpredictable according to any of the initial variables. Half of the patients who were abstinent immediately after discharge remained totally so at long-term follow-up. Total abstinence was obtained for 39 percent of patients during a mean period of 27 +/- 34 months. Medical, social, or psychological improvement was observed more often in abstainers (61 percent) than in non abstainers (11 percent, P less than 0.001). We conclude that: a) long-term follow-up and abstinence were infrequently obtained in unselected alcoholic patients hospitalized in a liver unit; b) no initial criteria could predict the alcoholic relapse or select patients for alcoholism treatment; c) long-term results seemed more favorable when the patients where totally abstinent immediately after discharge.

Adult↗
PubMed1990

[Obstructive icterus in patients with hepatic tumor. Result of non-surgical biliary drainage].

Seventeen patients with biliary obstruction and hepatic tumors were treated by endoscopic or percutaneous transhepatic drainage with an endoprothesis. There were 9 men and 8 women (mean age = 61 +/- 13 years). Four patients had primary hepatic carcinoma and 13 had hepatic metastases. Decrease of serum bilirubin of more than 75 percent was achieved in 12 of the patients (71 percent). The success rate was related to the level of the biliary obstacle and not to the importance of hepatic parenchymal involvement. Failure was significantly more frequent (p = 0.003) in patients with type III hilar strictures compared to the other patients with pedicular or type I and II hilar strictures. Cholangitis was the major complication (29 percent) and occurred only in the patients with type III hilar strictures. Mortality was 24 percent at 30 days. This rate was 57 percent in the group of patients with type III hilar strictures and significantly higher (p = 0.015) than other patients. Cumulative survival was better in patients with relief of jaundice than that observed in the other patients (p less than 0.01). Two patients with metastatic carcinoma of the breast treated by chemotherapy survived more than 20 months without jaundice. Analysis of these data indicates that in patients with hepatic tumors and obstructive jaundice, palliative treatment with endoprothesis can provide relief of jaundice and that prolonged survival may be observed in patients with chemosensible tumors.

Aged↗
PubMed1990

[Effect of alcohol and cirrhosis on the presence of Helicobacter pylori in the gastric mucosa].

The aim of this study was to determine whether there was any relationship between alcohol consumption, cirrhosis and Helicobacter pylori associated antral gastritis. One hundred and forty-four patients undergoing upper gastrointestinal endoscopy were prospectively included and classified in four groups. The first group of 23 patients had cirrhosis and an alcohol consumption below 80 g per day. The second group of 31 patients had cirrhosis and an alcohol consumption over 80 g per day. The third group of 34 patients had an alcohol consumption over 80 g per day without cirrhosis. The fourth group of 56 patients had an alcohol consumption below 80 g per day without any preexisting liver disease and underwent upper gastrointestinal endoscopy for non specific digestive symptoms. The diagnosis of Helicobacter pylori was made at histological examination using the hematoxylin and eosin stain and the Whartin-Starry stain in each case. Histopathological results were confirmed by a bacteriological study in 15 cases. One hundred and twelve of 144 patients (78 percent) had gastritis. Gastritis was more frequent (p less than 0.01) when Helicobacter pylori was present than when it was not (90 percent vs 68 percent). Gastritis was more frequent when alcohol consumption was high (86 percent vs 72 percent). Helicobacter pylori was found in 26 percent of the first group, 48 percent of the second group, 65 percent of the third group and 45 percent of the fourth group. These differences were significantly different (p less than 0.05). A statistically significant relationship between high alcohol consumption and the presence of Helicobacter pylori was noted, even in the presence of cirrhosis (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗