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Gaz digestifsDigestive gas
EMC - Hépato-Gastroenterologie Pub Date : 2005-10-01 DOI: 10.1016/j.emchg.2005.07.001
L. Peyrin-Biroulet, M. Bigard
{"title":"Gaz digestifsDigestive gas","authors":"L. Peyrin-Biroulet, M. Bigard","doi":"10.1016/j.emchg.2005.07.001","DOIUrl":"https://doi.org/10.1016/j.emchg.2005.07.001","url":null,"abstract":"","PeriodicalId":100426,"journal":{"name":"EMC - Hépato-Gastroenterologie","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2005-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85953278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Hémorragies digestives et radiologie interventionnelle 消化出血和介入放射学
EMC - Hépato-Gastroenterologie Pub Date : 2005-10-01 DOI: 10.1016/J.EMCHG.2005.09.002
P. Bulois, G. Sergent-Baudson, C. L'hermine, J. Paris
{"title":"Hémorragies digestives et radiologie interventionnelle","authors":"P. Bulois, G. Sergent-Baudson, C. L'hermine, J. Paris","doi":"10.1016/J.EMCHG.2005.09.002","DOIUrl":"https://doi.org/10.1016/J.EMCHG.2005.09.002","url":null,"abstract":"","PeriodicalId":100426,"journal":{"name":"EMC - Hépato-Gastroenterologie","volume":"9 1","pages":"388-399"},"PeriodicalIF":0.0,"publicationDate":"2005-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88475855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Conduite à tenir devant une ascite 在腹水前的行为
EMC - Hépato-Gastroenterologie Pub Date : 2005-10-01 Epub Date: 2005-08-18 DOI: 10.1016/j.emchg.2005.07.005
J.-D. Grangé
{"title":"Conduite à tenir devant une ascite","authors":"J.-D. Grangé","doi":"10.1016/j.emchg.2005.07.005","DOIUrl":"https://doi.org/10.1016/j.emchg.2005.07.005","url":null,"abstract":"<div><p>Ascites is the most common complication of cirrhosis. Approximately 50% of patients with compensated cirrhosis will develop ascites over a 10-year period. Ascites is associated with increased risks of infections, renal failure and poor long-term outcome. Abstinence from alcohol, salt restriction and diuretics are the mainstays of the therapy, and these measures are effective in approximately 90% of the patients. Treatment options for diuretic-resistant patients include serial therapeutic paracentesis and transjugular intrahepatic portosystemic stent-shunts. Patients eligible for liver transplantation should undergo evaluation for this procedure after development of ascites. A diagnostic paracentesis should be performed on hospital admission in any cirrhotic patient with ascites to investigate the presence of spontaneous bacterial peritonitis. In patients with an ascetic fluid PMN cell count<!--> <!-->&gt;<!--> <!-->250/mm<sup>3</sup>, antibiotic therapy (cefotaxime or amoxicillin-clavulanic acid) and albumin infusion need to be started before obtaining the results of ascites or blood cultures. Prophylactic antibiotic administration is recommended in cirrhotic patients hospitalized with upper gastrointestinal haemorrhage or low ascites protein (i.e.<!--> <!-->&lt;<!--> <!-->10 g/l) and in patients recovering from an episode of spontaneous bacterial peritonitis.</p></div>","PeriodicalId":100426,"journal":{"name":"EMC - Hépato-Gastroenterologie","volume":"2 4","pages":"Pages 297-306"},"PeriodicalIF":0.0,"publicationDate":"2005-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emchg.2005.07.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91718616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Récidive de la maladie initiale 最初疾病的复发
EMC - Hépato-Gastroenterologie Pub Date : 2005-10-01 Epub Date: 2005-05-23 DOI: 10.1016/j.emchg.2005.04.003
D. Samuel (Professeur d'hépatologie), E. Kimmoun
{"title":"Récidive de la maladie initiale","authors":"D. Samuel (Professeur d'hépatologie),&nbsp;E. Kimmoun","doi":"10.1016/j.emchg.2005.04.003","DOIUrl":"10.1016/j.emchg.2005.04.003","url":null,"abstract":"<div><p>Since rejection has become better controlled, recurrence of the initial disease on the graft is the most important problem after liver transplantation. Recurrence of the initial disease has been established for the B and C hepatitis and the hepatocellular carcinoma. The diagnosis of recurrence of biliary and auto-immune diseases is difficult and depends on a series of arguments. Hepatitis B recurrence is prevented by injection of anti-HBs immunoglobulin and anti viral therapy whereas hepatitis C is more hardly controlled. The period preceding liver transplantation is the moment of choice to limit the risk of recurrence, by treating the hepatitis C and confirming alcohol abstinence. Optimised management of the alcoholic disease allows decreasing its recurrence. The treatment of hepatitis C recurrence after liver transplantation is under evaluation. The ideal immunosuppression to limit recurrences of hepatitis C and biliary and auto-immune diseases is not currently known. In some cases, the only treatment is re-transplantation.</p></div>","PeriodicalId":100426,"journal":{"name":"EMC - Hépato-Gastroenterologie","volume":"2 4","pages":"Pages 348-361"},"PeriodicalIF":0.0,"publicationDate":"2005-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emchg.2005.04.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75099332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assistance nutritionnelle au cours des insuffisances hépatocellulaires 肝细胞衰竭期间的营养援助
EMC - Hépato-Gastroenterologie Pub Date : 2005-10-01 Epub Date: 2005-09-01 DOI: 10.1016/j.emchg.2005.08.001
X. Hébuterne
{"title":"Assistance nutritionnelle au cours des insuffisances hépatocellulaires","authors":"X. Hébuterne","doi":"10.1016/j.emchg.2005.08.001","DOIUrl":"https://doi.org/10.1016/j.emchg.2005.08.001","url":null,"abstract":"<div><p>Protein energy malnutrition is particularly frequent and severe in cirrhotic patients and may be determined by the routine measure of the mid-arm muscle circumference. The reasons for malnutrition include various factors such as anorexia, poor diet, and altered metabolic state. When the patient is hospitalized, malnutrition is frequently worsened due to the test-related necessity of fasting, continued anorexia, and complications such as gastrointestinal bleeding. Dietetic recommendations must be done to all patients. In cirrhotic patients energy needs are about 30 to 35 kcal/d with 1.2 to 1.5 g/d of protein. Oral supplementation with vitamins is often mandatory. Many studies have now clearly demonstrated that in malnourished patients nutrition support may improve outcome. In case of moderate malnutrition oral supplement enriched with branched chain amino acids may be useful. In case of severe malnutrition in hospitalized patients, enteral nutrition may be considered. Peri-operative nutrition support should be considered before surgery for hepatocellular carcinoma or liver transplantation.</p></div>","PeriodicalId":100426,"journal":{"name":"EMC - Hépato-Gastroenterologie","volume":"2 4","pages":"Pages 319-329"},"PeriodicalIF":0.0,"publicationDate":"2005-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emchg.2005.08.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91718618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Amylose hépatique Amylose hépatique
EMC - Hépato-Gastroenterologie Pub Date : 2005-10-01 Epub Date: 2005-08-18 DOI: 10.1016/j.emchg.2005.07.004
T. Dao , K. Bouhier , R. Gloro , V. Rouleau , P. Rousselot
{"title":"Amylose hépatique","authors":"T. Dao ,&nbsp;K. Bouhier ,&nbsp;R. Gloro ,&nbsp;V. Rouleau ,&nbsp;P. Rousselot","doi":"10.1016/j.emchg.2005.07.004","DOIUrl":"https://doi.org/10.1016/j.emchg.2005.07.004","url":null,"abstract":"<div><p>Amyloidosis is a disease characterized by the extracellular deposition of insoluble fibrillar protein amyloid in organs or tissues. The liver is a common site of amyloidal deposition in amyloidosis AL and AA. There is a poor correlation between the amount of amyloid and the degree of hepatic impairment. Hepatomegaly is the most typical clinical feature, contrasting with mild liver tests abnormalities, the most common being an isolated elevation of alkaline phosphatase. Histological analysis of biopsy specimens is the only method to establish the diagnosis of amyloidosis but liver biopsy carries a risk of bleeding. Less invasive alternatives are rectal biopsy and subcutaneous fat aspiration or biopsy. Scintigraphy with radiolabeled serum amyloid (SAP) component is emerging as a non invasive technique for detecting, localizing, quantifying amyloid deposits and for monitoring treatment. The prognosis of amyloidosis AL is poor (median survival 9 months) despite systemic chemotherapy. Results of high dose chemotherapy associated with peripheral blood stem cell transplantation remain to assess. Prognosis of amyloidosis AA depends on treatment of the causal disease.</p></div>","PeriodicalId":100426,"journal":{"name":"EMC - Hépato-Gastroenterologie","volume":"2 4","pages":"Pages 330-338"},"PeriodicalIF":0.0,"publicationDate":"2005-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emchg.2005.07.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91718052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Physiopathologie du reflux gastro-œsophagien
EMC - Hépato-Gastroenterologie Pub Date : 2005-10-01 Epub Date: 2005-09-22 DOI: 10.1016/j.emchg.2005.09.001
P. Ducrotté (Professeur des Universités, médecin des Hôpitaux), U. Chaput (Interne des Hôpitaux de Rouen)
{"title":"Physiopathologie du reflux gastro-œsophagien","authors":"P. Ducrotté (Professeur des Universités, médecin des Hôpitaux),&nbsp;U. Chaput (Interne des Hôpitaux de Rouen)","doi":"10.1016/j.emchg.2005.09.001","DOIUrl":"https://doi.org/10.1016/j.emchg.2005.09.001","url":null,"abstract":"<div><p>Gastro-œsophageal reflux (GORD) is a multifactorial disease. The key factor in the pathogenesis of GORD is a disordered function of the lower oesophageal sphincter (LOS). Before the description of the dynamics of LOS function, a chronically decreased LOS pressure was considered to be the most important pathogenic mechanism. Then, transient relaxations of the LOS were found to be the most prevalent mechanism of reflux episodes. Recent investigations have pointed out the role of the crural diaphragm which strengthens the LOS in the absence of a hiatus hernia. All of altered oesophageal motility leading to an impaired oesophageal clearance, delayed gastric emptying, abnormal composition of the refluxate and abnormalities in the defensive capacity of the oesophageal mucosa are also important factors in the onset of symptoms and reflux oesophagitis.</p></div>","PeriodicalId":100426,"journal":{"name":"EMC - Hépato-Gastroenterologie","volume":"2 4","pages":"Pages 362-369"},"PeriodicalIF":0.0,"publicationDate":"2005-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emchg.2005.09.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91718055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Hémorragies digestives et radiologie interventionnelle 消化出血和介入放射学
EMC - Hépato-Gastroenterologie Pub Date : 2005-10-01 Epub Date: 2005-10-19 DOI: 10.1016/j.emchg.2005.09.002
P. Bulois , G. Sergent-Baudson , C. L'Herminé , J.-C. Paris
{"title":"Hémorragies digestives et radiologie interventionnelle","authors":"P. Bulois ,&nbsp;G. Sergent-Baudson ,&nbsp;C. L'Herminé ,&nbsp;J.-C. Paris","doi":"10.1016/j.emchg.2005.09.002","DOIUrl":"https://doi.org/10.1016/j.emchg.2005.09.002","url":null,"abstract":"<div><p>Radiological techniques and therapy are an important component of the armentarium in evaluating and treating gastro intestinal bleeding, particularly when the bleeding site is obscure or undetermined after thorough endoscopic evaluation, when the bleeding is massive or refractory to endoscopic therapy. Major breakthroughs in catheter and guidewire design as well as improvements in angiographic x-ray equipment currently allow interventional radiologists to diagnose massive life-threatening upper and lower gastro intestinal haemorrhage and to stop the bleeding safely and effectively using superselective catheterization and microcoil embolization. Gastrointestinal bleeding, especially when severe or refractory, is best managed by a team approach with the team including the radiologist, internist, gastroenterologist, and surgeon.</p></div>","PeriodicalId":100426,"journal":{"name":"EMC - Hépato-Gastroenterologie","volume":"2 4","pages":"Pages 388-399"},"PeriodicalIF":0.0,"publicationDate":"2005-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emchg.2005.09.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91718054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Prédisposition héréditaire au cancer colorectal et inactivation de la fonction de réparation des mésappariements de l'ADN 结直肠癌的遗传易感性和dna配对修复功能的失活
EMC - Hépato-Gastroenterologie Pub Date : 2005-07-01 Epub Date: 2005-04-19 DOI: 10.1016/j.emchg.2005.03.002
S. Olschwang , (pour les experts rédacteurs du rapport confié au ministre de la Santé le 31 décembre 2003 : C. Bonaiti-Pellié, F. Eisinger, J. Feingold, T. Frébourg, S. Grandjouan, C. Lasset, P. Laurent-Puig, F. Lecuru, B. Millat, H. Sobol, G. Thomas), F. Eisinger
{"title":"Prédisposition héréditaire au cancer colorectal et inactivation de la fonction de réparation des mésappariements de l'ADN","authors":"S. Olschwang ,&nbsp;(pour les experts rédacteurs du rapport confié au ministre de la Santé le 31 décembre 2003 : C. Bonaiti-Pellié, F. Eisinger, J. Feingold, T. Frébourg, S. Grandjouan, C. Lasset, P. Laurent-Puig, F. Lecuru, B. Millat, H. Sobol, G. Thomas),&nbsp;F. Eisinger","doi":"10.1016/j.emchg.2005.03.002","DOIUrl":"10.1016/j.emchg.2005.03.002","url":null,"abstract":"<div><p>The hereditary non-polyposis colorectal cancer (HNPCC) syndrome is an inherited condition characterized by clinical and genealogical criteria (Amsterdam criteria), caused by germline mutations in <em>MMR</em> genes in about 70% of cases. In this situation, tumor cells exhibit an MSI phenotype that is evidenced by genotyping of a reference panel of 5 monucleotidic sequences. Gene carriers are at high-risk of developing colorectal, endometrial, urothelial and small intestine carcinomas, and at moderate risk of ovary, stomach and biliary tract carcinomas. Genetic counseling is based on the presence of a carcinoma belonging to one of these locations, diagnosed before the age of 40, or before 60 years in case of MSI phenotype or an affected first degree relative. Identification of germline MMR gene is an important step for recommendations of subsequent surveillance and follow-up, focused on main cancer risks, i.e. colorectum and endometrium.</p></div>","PeriodicalId":100426,"journal":{"name":"EMC - Hépato-Gastroenterologie","volume":"2 3","pages":"Pages 214-222"},"PeriodicalIF":0.0,"publicationDate":"2005-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emchg.2005.03.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87386476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Motricité du côlon et du rectum 结肠和直肠的运动能力
EMC - Hépato-Gastroenterologie Pub Date : 2005-07-01 Epub Date: 2005-02-12 DOI: 10.1016/j.emchg.2005.01.007
P. Ducrotté (Professeur des Universités, praticien hospitalier), G. Gourcerol (Interne des Hôpitaux)
{"title":"Motricité du côlon et du rectum","authors":"P. Ducrotté (Professeur des Universités, praticien hospitalier),&nbsp;G. Gourcerol (Interne des Hôpitaux)","doi":"10.1016/j.emchg.2005.01.007","DOIUrl":"https://doi.org/10.1016/j.emchg.2005.01.007","url":null,"abstract":"<div><p>The large bowel has two main functions: the absorption of water and electrolytes unabsorbed in the small bowel and the storage of stools between bowel movements. Colonic motor patterns are both tonic and phasic contractions. Phasic contractions are, in most of the cases, short clustered and non propagated contractions, separated by long periods of motor rest, especially at night. However, the most characterized colonic motor patterns are high-amplitude propagated contractions, occurring mainly at awakening and after meals and promoting aboral movements of the colonic content. Colonic nervous structures are both intrinsic and extrinsic. Intrinsic structures are the two plexuses of the enteric nervous system but also intestitial cells of Cajal. Extrinsic innervation plays a major role in modulating intrinsic nervous control, mainly after the meals that remain the major stimulant of colonic motility. Rectum and anal sphincters are essential for both defecation and continence. Their physiology involves smooth and striated muscles. The nervous control of recto-anal motility depends again from both intrinsic et extrinsic structures. Sensory nerves are key factor for continence.</p></div>","PeriodicalId":100426,"journal":{"name":"EMC - Hépato-Gastroenterologie","volume":"2 3","pages":"Pages 177-188"},"PeriodicalIF":0.0,"publicationDate":"2005-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emchg.2005.01.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92036053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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