Introduction: After an episode of spontaneous infection of ascitic fluid (ISLA). The recurrence of ISLA at one year is greater than 70%. We studied the risk factors associated with the occurrence of recurrence. Patien...Introduction: After an episode of spontaneous infection of ascitic fluid (ISLA). The recurrence of ISLA at one year is greater than 70%. We studied the risk factors associated with the occurrence of recurrence. Patients and methods: this was a retrospective, descriptive and analytical study of patient files, hospitalized in the department for 12 months, the choice of the sample was of convenience. Results: We have 1347 patient files collected including 389 cases of cirrhosis. We had 37 files of cirrhotic patients with ISLA including 28 cures without recurrence of ISLA, 08 files of patients with recurrence of ISLA and 03 excluded, i.e. a hospital prevalence of recurrence of 0.6% and a prevalence in cirrhotic patients of 23.5%. The most common antecedents were: hospital contact recent (35.3%), the concept of iterative ascites punctures (32.3%), the presence of HCC (29.4%), hepatic encephalopathy (20.6%) and digestive hemorrhage (14.7%). In univariate analysis, recent digestive bleeding was associated with an increased risk of recurrence (OR 7.2, 95% CI 0.96 - 67.1). HBV (62.5%) is the main etiology of cirrhosis. The PNN rate at 250 - 499 mm3 (62.5%), the protein level 3 (75%). Patients on secondary prophylaxis with NORFLOXACIN were 25%. Recurrence of ISLA was treated with CEFTRIAXONE 2 g/24 hours. Conclusion: Recurrence of ISLA is serious, the predictive factors for recurrence are, hospital contact recent, the concept of iterative ascites punctures, the presence of HCC, the presence of hepatic encephalopathy and digestive bleeding.展开更多
Introduction: Oesophageal mycosis (OM) is one of the most common opportunistic infections in patients infected with HIV (Human Immunodeficiency Virus). However, this condition is increasingly observed in immunocompete...Introduction: Oesophageal mycosis (OM) is one of the most common opportunistic infections in patients infected with HIV (Human Immunodeficiency Virus). However, this condition is increasingly observed in immunocompetent subjects. The aim of this study was to determine the endoscopic prevalence, clinical characteristics and risk factors for the occurrence of oesophageal mycosis in our department. Patients and Method: This was a prospective cross-sectional study of all patients who underwent oeso-gastroduodenal fibroscopy during the period from 1<sup>st </sup>January to 31<sup>st</sup> December 2022, i.e. one year, at the digestive endoscopy unit of the hepato-gastroenterology department of the Donka CHU national hospital in Conakry. All patients found to have oesophageal mycosis by FOGD were included. The endoscopy was performed using appropriate equipment: A Fujinon 4400 video endoscopy column;Three Fujinon EG 590 video gastroscopes;A hoover;Data were collected using a pre-established survey form and analysed using Epi info software version 6.0.4;Pearson’s Chi2 test as a test of independence and the exact 5% threshold ficher test. Results: Out of 1343 upper gastrointestinal endoscopies performed, 107 cases of oesophageal mycosis were found, representing a prevalence of 7.96%. The mean age was 40 years, with a male predominance of 55.42%. The sex ratio M/F was 1.24. The 45 and over age group was the most affected, with a prevalence of 40.43%, followed by the [35 - 45] age group, with a prevalence of 22.43%. Clinical symptoms were dominated by epigastralgia in 74.76% of cases, followed by odynophagia in 37.38% of cases, nausea and vomiting in 28.03% of cases, and pyrosis in 26.16% of cases. Oesophageal mycosis without oesophagitis was the most common endoscopic finding in 70% of cases. The main associated endoscopic lesions were erythemato-erosive and congestive gastropathy in 28.03% of cases, peptic oesophagitis (9.34%) and gastric ulcer (5.60%). The main risk factors found were positive HIV serology in 39.25% o展开更多
Introduction: Gastric infection by “Helicobacter pylori” remains a topical issue due to the evolving scientific data concerning its pathophysiology, the diseases and pathologies concerned, which now extend beyond th...Introduction: Gastric infection by “Helicobacter pylori” remains a topical issue due to the evolving scientific data concerning its pathophysiology, the diseases and pathologies concerned, which now extend beyond the gastric or digestive sphere, and the treatment methods faced with the development of antibiotic resistance. Diagnosis of infection involves two inseparable aspects: identification of the bacterium itself and identification of the endoscopic and histological lesions caused by the bacterium. Objective: To evaluate the rate of eradication of Helicobacter pylori infection by bismuth quadruple therapy and concomitant treatment. Patients and methods: This was a prospective, cross-sectional, analytical study of all outpatients in the hepato-gastroenterology department during the study period from 1 January 2022 to 30 November 2023. All patients had undergone oeso-gastroduodenal fibroscopy and the diagnosis was made by histological examination of the gastric biopsy. Results: Our 113 patients comprised 68 men and 46 women. The sex ratio was 1.48 in favour of men. The mean age of our patients was 40.28 years, with extremes of 13 and 80 years. The clinical signs that prompted oeso-gastroduodenal fibroscopy were as follows: epigastralgia (69.91%), dyspepsia (14.16%), vomiting (7.08%), gastro-oesophageal reflux (6.19%) and altered general condition with weight loss (2.65%). The endoscopic lesions were: gastropathy (antral, fundic and diffuse: antro-fundial) (69.02%), bulbar ulcer (6.19%), gastric ulcer (5.31%). Helicobacter pylori infection was associated with chronic gastritis in all our patients;it was mild in 50%, moderate in 41% and severe in 9%. The eradication rate of Helicobacter pylori according to the treatment protocol used was 92.30% for bismuth quadruple therapy and 94.12% for concomitant quadruple therapy. Conclusion: The eradication rate of Helicobacter pylori in our study was 92.30% and 94.12% respectively for bismuth quadritherapy and concomitant therapy. Therapeutic compliance was good in 89.展开更多
文摘Introduction: After an episode of spontaneous infection of ascitic fluid (ISLA). The recurrence of ISLA at one year is greater than 70%. We studied the risk factors associated with the occurrence of recurrence. Patients and methods: this was a retrospective, descriptive and analytical study of patient files, hospitalized in the department for 12 months, the choice of the sample was of convenience. Results: We have 1347 patient files collected including 389 cases of cirrhosis. We had 37 files of cirrhotic patients with ISLA including 28 cures without recurrence of ISLA, 08 files of patients with recurrence of ISLA and 03 excluded, i.e. a hospital prevalence of recurrence of 0.6% and a prevalence in cirrhotic patients of 23.5%. The most common antecedents were: hospital contact recent (35.3%), the concept of iterative ascites punctures (32.3%), the presence of HCC (29.4%), hepatic encephalopathy (20.6%) and digestive hemorrhage (14.7%). In univariate analysis, recent digestive bleeding was associated with an increased risk of recurrence (OR 7.2, 95% CI 0.96 - 67.1). HBV (62.5%) is the main etiology of cirrhosis. The PNN rate at 250 - 499 mm3 (62.5%), the protein level 3 (75%). Patients on secondary prophylaxis with NORFLOXACIN were 25%. Recurrence of ISLA was treated with CEFTRIAXONE 2 g/24 hours. Conclusion: Recurrence of ISLA is serious, the predictive factors for recurrence are, hospital contact recent, the concept of iterative ascites punctures, the presence of HCC, the presence of hepatic encephalopathy and digestive bleeding.
文摘Introduction: Oesophageal mycosis (OM) is one of the most common opportunistic infections in patients infected with HIV (Human Immunodeficiency Virus). However, this condition is increasingly observed in immunocompetent subjects. The aim of this study was to determine the endoscopic prevalence, clinical characteristics and risk factors for the occurrence of oesophageal mycosis in our department. Patients and Method: This was a prospective cross-sectional study of all patients who underwent oeso-gastroduodenal fibroscopy during the period from 1<sup>st </sup>January to 31<sup>st</sup> December 2022, i.e. one year, at the digestive endoscopy unit of the hepato-gastroenterology department of the Donka CHU national hospital in Conakry. All patients found to have oesophageal mycosis by FOGD were included. The endoscopy was performed using appropriate equipment: A Fujinon 4400 video endoscopy column;Three Fujinon EG 590 video gastroscopes;A hoover;Data were collected using a pre-established survey form and analysed using Epi info software version 6.0.4;Pearson’s Chi2 test as a test of independence and the exact 5% threshold ficher test. Results: Out of 1343 upper gastrointestinal endoscopies performed, 107 cases of oesophageal mycosis were found, representing a prevalence of 7.96%. The mean age was 40 years, with a male predominance of 55.42%. The sex ratio M/F was 1.24. The 45 and over age group was the most affected, with a prevalence of 40.43%, followed by the [35 - 45] age group, with a prevalence of 22.43%. Clinical symptoms were dominated by epigastralgia in 74.76% of cases, followed by odynophagia in 37.38% of cases, nausea and vomiting in 28.03% of cases, and pyrosis in 26.16% of cases. Oesophageal mycosis without oesophagitis was the most common endoscopic finding in 70% of cases. The main associated endoscopic lesions were erythemato-erosive and congestive gastropathy in 28.03% of cases, peptic oesophagitis (9.34%) and gastric ulcer (5.60%). The main risk factors found were positive HIV serology in 39.25% o
文摘Introduction: Gastric infection by “Helicobacter pylori” remains a topical issue due to the evolving scientific data concerning its pathophysiology, the diseases and pathologies concerned, which now extend beyond the gastric or digestive sphere, and the treatment methods faced with the development of antibiotic resistance. Diagnosis of infection involves two inseparable aspects: identification of the bacterium itself and identification of the endoscopic and histological lesions caused by the bacterium. Objective: To evaluate the rate of eradication of Helicobacter pylori infection by bismuth quadruple therapy and concomitant treatment. Patients and methods: This was a prospective, cross-sectional, analytical study of all outpatients in the hepato-gastroenterology department during the study period from 1 January 2022 to 30 November 2023. All patients had undergone oeso-gastroduodenal fibroscopy and the diagnosis was made by histological examination of the gastric biopsy. Results: Our 113 patients comprised 68 men and 46 women. The sex ratio was 1.48 in favour of men. The mean age of our patients was 40.28 years, with extremes of 13 and 80 years. The clinical signs that prompted oeso-gastroduodenal fibroscopy were as follows: epigastralgia (69.91%), dyspepsia (14.16%), vomiting (7.08%), gastro-oesophageal reflux (6.19%) and altered general condition with weight loss (2.65%). The endoscopic lesions were: gastropathy (antral, fundic and diffuse: antro-fundial) (69.02%), bulbar ulcer (6.19%), gastric ulcer (5.31%). Helicobacter pylori infection was associated with chronic gastritis in all our patients;it was mild in 50%, moderate in 41% and severe in 9%. The eradication rate of Helicobacter pylori according to the treatment protocol used was 92.30% for bismuth quadruple therapy and 94.12% for concomitant quadruple therapy. Conclusion: The eradication rate of Helicobacter pylori in our study was 92.30% and 94.12% respectively for bismuth quadritherapy and concomitant therapy. Therapeutic compliance was good in 89.