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A Rare Cause of Gastrointestinal Bleeding: Cholecystoenteric Fistula

Case Reports in Clinical Medicine 2014年第9期3卷 521-523页

作者： Iliass Charif Hossam Benhammane Dafr-Allah Benajah Said ait Laalim Khalid Mazaz adil Ibrahimi Mounia El Yousfi Department of Gastroenterology Hassan II University Hospital Faculty of Medicine and Pharmacy of Fez Sidi Mohammed Ben Abdellah University Fez Morocco Department of Surgery Hassan II University Hospital Faculty of Medicine and Pharmacy of Fez Sidi Mohammed Ben Abdellah University Fez Morocco

A 60-year-old woman presented to the emergency department of our university hospital for several episodes of upper gastro-intestinal bleeding (hematemesis and melena). The endoscopic examination (Figure 1) showed a large ulcer at the front of the bulb, with a calculation within it and a visible vessel on the banks of the ulcer treated by putting two clips. Computer tomography (CT), demonstrated a sclerotic, atrophic and multi gallstone gallbladder, with a calculation protruding in the duodenum. The patient underwent surgery which consisted on partial cholecystectomy with duodenal suture and closing of cystic duct.

关键词： Gastrointestinal Bleeding Cholecystoenteric Fistula

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Inoperable Pancreatic Metastasis of Renal Cell Carcinoma: A Case Report and a Review of Literature

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Journal of Cancer Therapy 2017年第2期8卷 168-172页

作者： Hanae Bedoudou Lamiae Boudahna adil Mai Boubacar Efared Said ait Laalim Laila Chbani Youssef Alaoui Lamrani Nawfel Mellas Medical Oncology Department University Hospital Hassan II Fez Morocco Radiology Department University Hospital Hassan II Fez Morocco Anatomical Pathology and Cytology Laboratory University Hospital Hassan II Fez Morocco General Surgery Department University Hospital Hassan II Fez Morocco

Renal cell carcinoma (RCC) is a common cancer, but its pancreatic metastasis is unusual. We report a case of a 50-year-old male who was under the first line of treatment for a metastatic RCC since 2009. In August 2015, he showed up to the day unit with a cholestatic jaundice, and the investigations led to the discovery of a liver function alteration and a pancreatic mass. The biopsy of the inoperable mass revealed a RCC metastasis. The localization of this metastasis complicated the management of the disease due to haemorrhage and anemia. An embolization was performed to control the local complications. The patient was commenced on everolimus but with modest results forcing us to start exclusive palliative care.

关键词： Renal Cell Carcinoma Biopsy Pancreatic Metastasis Inoperable Everolimus

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Surgical Bypass versus Endoscopic Stenting for Unresectable Head Pancreatic Cancer, Which Palliative Treatment Is Better in Developing Countries, Morocco as an Example

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Open Journal of Gastroenterology 2017年第5期7卷 154-164页

作者： Khalid Mazine Hamdaoui Mohammed El Ghazi Karima Ousadden Abdelmalek Mazaz Khalid Ibrahimi adil ait Taleb Khalid Benajeh Dafrallah Benjelloun Elbachir Department of Visceral Surgery Faculty of Medicine and Pharmacy of Fez University Hospital Hassan II—Fes Sidi Mohamed Ben Abdellah University Fez Morocco

Background: Metal stents for unresectable pancreatic cancer are associated with longer patency and superior cost-effectiveness. However, they are too expensive to be recommended routinely in developing countries. Moreover, a debate on outcome results in these patients who receive plastic biliary endoprothesis versus surgical bypass as palliation of obstructive jaundice. We aimed to compare retrospectively the outcomes in patients treated with plastic stent or surgical bypass as a palliative option for these patients. Patients and Methods: We have examined data for patients (n = 86) who received endoscopic stenting (n = 64) or surgical bypass (n = 22), from January 2013 to November 2016, as a palliative treatment for obstructive jaundice from inoperable cancer head pancreas. Results: Serum bilirubin and CA19.9 levels were comparable in age and gender matched patient groups. Moreover, post-operative major complications and 30-days mortality showed no significant differences among patient groups. However, surgical bypass treated patients showed longer initial hospital stay (9 vs. 6 days, p = 0.014), higher cost ($1600 vs. $1088) and longer survival (192 vs. 101 days, p = 0.003) compared to endoscopy-stenting treated patients. Re-hospitalization was required for 5 stented patients (averaged $448). Conclusion: Biliary bypass surgery for unresectable pancreatic cancer may improve patient survival, although prolongs hospital stay. It may be recommended for relatively fit patients with a life expectancy of 6 months and more.

关键词： Pancreatic Carcinoma Jaundice Palliative Treatment Biliary Bypass Endoscopy Stent

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Role of macroscopic on-site evaluation of endoscopic ultrasoundguided fine-needle aspiration/biopsy:Results of a multicentric prospective study

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World Journal of Gastrointestinal Endoscopy 2024年第11期16卷 595-606页

作者： Hussein H Okasha Hiwa A Hussein Khaled M Ragab Omar Abdallah Fedoua Rouibaa Borahma Mohamed Fahd Ghalim Mahmoud Farouk Mohamed Lasheen Mohamed A Elbasiony Ahmed E Alzamzamy Ahmed El Deeb Hassan Atalla Mahmoud El-Ansary Sahar Mohamed Moaz Elshair Wafaa Khannoussi Mohamed Z Abu-Amer Amine Elmekkaoui Mohammed S Naguib adil ait erram. Ahmed El-Meligui Ahmed H El-Habashi Mahmoud G Ameen Dalia Abdelfatah Mona Kaddah Hanane Delsa Division of Gastroenterology and Hepatology Department of Internal MedicineKasr Al-Aini School of MedicineCairo UniversityCairo 11562Egypt Sulaimani Center for Advanced Gastrointestinal Endoscopy Sulaimani College of MedicineSulaymaniyah 46001Iraq Department of Hepatology and Gastroenterology Theodor Bilharz Research InstituteCairo 11211Egypt Hepatology and Gastroenterology Unit Department of Internal MedicineMansoura UniversityFaculty of MedicineMansoura 35516Egypt Gastrointestinal Endoscopy Center Military Hospital Mohamed VFaculty of Medicine of RabatRabat 10100Rabat-Salé-KénitraMorocco Department of Gastroenterology“C” Ibn Sina HospitalMohammed V University in RabatRabat 10000Rabat-Salé-KénitraMorocco Digestive Endoscopy Unit Mekka ClinicCasablanca 20000Casablanca-SettatMorocco Department of Tropical Medicine and Gastroenterology Luxor UniversityLuxor 85951Egypt Hepatology and Gastroenterology Unit Department of Internal MedicineFaculty of MedicineMansoura UniversityMansoura 35516Egypt Department of Gastroenterology and Hepatology Maadi Armed Forces Medical ComplexMilitary Medical AcademyCairo 11841Egypt Department of Gastroenterology National Hepatology and Tropical Medicine Research InstituteCairo 12556Egypt Department of Hepatology Gastroenterology and Infectious DiseasesFaculty of MedicineAl-Azhar UniversityCairo 11651Egypt Department of Gastroenterology and Endoscopy Center Cheikh Khalifa International University HospitalMohammed VI University of Sciences and HealthCasablanca 82403Casablanca-SettatMorocco Research Unit Mohammed VI Center for Research and InnovationRabat 10100Rabat-Salé-KénitraMorocco Department of Hepato-Gastroenterology Hassan II University Hospital of FezFaculty of MedicinePharmacy and Dentistry of FezSidi Mohamed Ben Abdellah UniversityFes 30003Fès-MeknèsMorocco Department of Gastroenterology Ahmed Maher Teaching HospitalCairo 11451Egypt Department of Gastroenterology Cadi Ayyad UniversityMohammed VIth University HospitalMarrakech

BACKGROUND The concept of macroscopic on-site evaluation(MOSE)was introduced in 2015 when the endoscopist observed better diagnostic yield when the macroscopically visible core on MOSE was superior to 4 *** studies suggest that MOSE by the endoscopist may be an excellent alternative to rapid on-site evaluation,and some classi-fications have been *** studies have assessed the adequacy of histologic cores in MOSE during endoscopic ultrasound-guided fine-needle aspiration/biopsy(EUS-FNA/FNB).AIM To evaluate the performance of MOSE during EUS-FNA/*** This multicentric prospective study was conducted in 16 centers in 3 countries(Egypt,Iraq,and Morocco)and included 1108 patients with pancreatic,biliary,or gastrointestinal pathology who were referred for EUS *** prospectively analyzed the MOSE in 1008 patients with available histopathological reports according to 2 classifications to determine the adequacy of the histological core *** management and analysis were performed using a Statistical Package for Social Sciences(SPSS)version *** A total of 1074 solid lesions were biopsied in 1008 patients with available cytopathological *** age was 59 years,and 509 patients(50.5%)were *** mean lesion size was 38 *** most frequently utilized needles were FNB-Franseen(74.5%)and 22 G(93.4%),with a median of 2 *** to 2 classifications,618 non-bloody cores(61.3%)and 964 good samples(95.6%)were adequate for histological *** overall diagnostic yield of cytopathology was 95.5%.The cytological examination confirmed the diagnosis of malignancy in 861 patients(85.4%),while 45 samples(4.5%)were ***-procedural adverse events occurred in 33 patients(3.3%).Statistical analysis showed a difference between needle types(P=0.035)with a high sensitivity of FNB(97%).The analysis of the relationship between the MOSE-score and the final diagnosis showed a significant difference between the different

关键词： Macroscopic on-site evaluation Fine-needle aspiration Fine-needle biopsy Endoscopic ultrasound Specimen

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