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Diagnosis by endoscopic ultrasound guided fine needle aspiration of tuberculous lymphadenitis involving the peripancreatic lymph nodes: A case report

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World Journal of Gastroenterology 2007年第3期13卷 474-477页

作者： joseph D boujaoude Khalil Honein Cesar Yaghi Claude Ghora Gerard Abadjian Raymond Sayegh Department of Gastroenterology Hotel-Dieu de France hospital Saint-Joseph University Beirut Lebanon Department of Pathology Hotel-Dieu de France hospital Saint-Joseph University Beirut Lebanon

Pancreatic tuberculosis is an extremely rare form of extrapulmonary disease. The diagnosis preoperatively is difficult because clinical, laboratory and radiologic findings are nonspecific. Published data indicate that these lesions mimic cystic neoplasms of the pancreas and the confirmation of clinical suspicion could only be obtained by an open surgical biopsy. Recently, fine needle aspiration cytology has been shown to be a safe, reliable and cost-effective alternative. We report a new case of a peripancreatic tuberculosis in a 52 year old woman and review the relevant literature, paying special attention to the usefulness of endoscopic ultrasound guided-fine needle aspiration in the diagnosis of abdominal tuberculosis.

关键词：内窥镜检查淋巴腺炎肺结核超声法诊断方法

Hepatocellular carcinoma in Lebanon: Etiology and prognostic factors associated with short-term survival

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World Journal of Gastroenterology 2006年第22期12卷 3575-3580页

作者： César Yaghi Ala I Sharara Paul Rassam Rami Moucari Khalil Honein joseph boujaoude Rita Slim Roger Noun Heitham Abdul-Baki Mohamad Khalifeh Sami Ramia Raymond Sayegh Service de Gastroenterologie Hotel Dieu de France University Hospital BeirutLebanon Service de Gastroenterologie Hotel Dieu de France University Hospital.Beirut.Lebanon Departments of Internal Medicine and Surgery American University of Beirut Medical CenterBeirutLebanon Service de Gastroenterologie Hotel Dieu de France University Hospital BeirutLebanon Service de GastroenterologieHopital Saint GeorgesBeirutLebanon Departments of Internal Medicine and Surgery American University of Beirut Medical Center BeirutLebanon

瞄准：在黎巴嫩和早死亡预兆的预示的因素学习 HCC 的传染病学。方法：在一个五年的时期上诊断的 HCC 盒子的观察后续队研究被执行。Multivariate 分析被进行与肝意大利的程序(片断) 分数的癌症相比识别预示的因素。包括内在的肝疾病，... 详细信息

瞄准：在黎巴嫩和早死亡预兆的预示的因素学习 HCC 的传染病学。方法：在一个五年的时期上诊断的 HCC 盒子的观察后续队研究被执行。Multivariate 分析被进行与肝意大利的程序(片断) 分数的癌症相比识别预示的因素。包括内在的肝疾病，病人的人口统计的特征，和孩子呸评估的肝疾病的严厉的病原学的多重变量得分被学习。肿瘤参数包括了小瘤，门静脉血栓的存在，和治疗形式的 HCC， alpha-fetoprotein 水平，数字和尺寸的诊断的时间。后续的死亡或损失被看作一个端点事件。结果：92 个病人(平均数 60.5 +/- 22.3 年) 被包括。内在的疾病的病原学分别地是在 67% ， 20% ，和 23.5% 的肝炎 B， C，和酒精。在诊断的孩子呸班分别地是在 34.8% ， 39.3% 和 25.8% 的 A， B，和 C。全面幸存分别地在 1， 2 和 3 年是 44.8% ， 32.8% 和 17.6%( 吝啬的 F/U 40.2 +/- 23.5 瞬间) 。Multivariate 分析识别了早死亡的三个预言者( 3.2 mg/dL (P 1 mg/dL (P = 0.017 ) 。一个分数由考克斯基于这些变量超过了片断分数比例的危险。巨鸟曲线显示了两个模型相等、中等精确。结论：HBV 是在黎巴嫩的 HCC 的领先的原因。早死亡的独立预言者是象疾病的第一表明的提高的胆红素，肌酸酐和 HCC。一个分数的未来的确认基于在预言短期的幸存的这些临床的参数被需要。

关键词：肝细胞癌黎巴嫩病原学生存质量

Digestive manifestations of parathyroid disorders

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World Journal of Gastroenterology 2011年第36期17卷 4063-4066页

作者： Bassam Abboud Ronald Daher Joe boujaoude Department of General Surgery Hotel Dieu de France HospitalFaculty of MedicineSaintJoseph UniversityBeirut 166830Lebanon Department of Gastroenterology Hotel Dieu de France HospitalFaculty of MedicineSaint-Joseph UniversityBeirut 166830Lebanon

The parathyroid glands are the main regulator of plasma calcium and have a direct influence on the digestive *** disturbances often result in unknown long-standing *** main manifestation of hypoparathyroidism is steatorrhea due to a deficit in exocrine pancreas *** association with celiac sprue may contribute to *** causes smooth-muscle atony,with upper and lower gastrointestinal symptoms such as nausea,heartburn and *** and peptic ulcer were strongly linked before the advent of proton pump ***,this association remains likely only in the particular context of multiple endocrine neoplasia type 1/Zollinger-Ellison *** contrast to chronic pancreatitis,acute pancreatitis due to primary hyperparathyroidism is one of the most studied *** causative effect of high calcium level is confirmed and the distinction from secondary hyperparathyroidism is *** digestive manifestations of parathyroid malfunction are often overlooked and serum calcium level must be included in the routine workup for abdominal symptoms.

关键词：甲状旁腺消化道系统表急性胰腺炎疾病质子泵抑制剂内分泌腺平滑肌收缩

Occult sporadic insulinoma: Localization and surgical strategy

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World Journal of Gastroenterology 2008年第5期14卷 657-665页

作者： Bassam Abboud Joe boujaoude Department of General Surgery Hotel Dieu de France Hospital Faculty of Medicine Saint-Joseph University Beirut 166830 Lebanon Department of Gastroenterology Hotel Dieu de France Hospital Faculty of Medicine Saint-Joseph University Beirut 166830 Lebanon

Insulinomas continue to pose a diagnostic challenge to physicians, surgeons and radiologists alike. Most are intrapancreatic, benign and solitary. Biochemical diagnosis is obtained and imaging techniques to localize lesions continue to evolve. Surgical resection is the treatment of choice. Despite all efforts, an occult insulinoma (occult insulinoma refers to a biochemically proven tumor with indeterminate anatomical site before operation) may still be encountered. New localization preoperative techniques decreases occult cases and the knowledge of the site of the mass before surgery allows to determine whether enucleation of the tumor or pancreatic resection is likely to be required and whether the tumor is amenable to removal via a laparoscopic approach. In absence of preoperative localization and intraoperative detection of an insulinoma, blind pancreatic resection is not recommended.

关键词：胰岛素瘤 CT扫描外科手术超声波扫描术腹腔镜检查

Acute mesenteric ischemia after cardio-pulmonary bypass surgery

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World Journal of Gastroenterology 2008年第35期14卷 5361-5370页

作者： Bassam Abboud Ronald Daher Joe boujaoude Department of General Surgery Hotel Dieu de France HospitalFaculty of MedicineSaint-Joseph UniversityBeirut 16-6830Lebanon Department of Gastroenterology Hotel Dieu de France HospitalFaculty of MedicineSaint-Joseph UniversityBeirut 16-6830Lebanon

Acute mesenteric ischemia (AMI) is a highly-lethal surgical emergency. Several pathophysiologic events (arterial obstruction, venous thrombosis and diffuse vasospasm) lead to a sudden decrease in mesenteric blood flow. Ischemia/reperfusion syndrome of the intestine is responsible for systemic abnormalities, leading to multi-organ failure and death. Early diagnosis is difficult because the clinical presentation is subtle, and the biological and radiological diagnostic tools lack sensitivity and specificity. Therapeutic options vary from conservative resuscitation, medical treatment, endovascular techniques and surgical resection and revascularization. A high index of suspicion is required for diagnosis, and prompt treatment is the only hope of reducing the mortality rate. Studies are in progress to provide more accurate diagnostic tools for early diagnosis. AMI can complicate the post-operative course of patients following cardio-pulmonary bypass (CPB). Several factors contribute to the systemic hypo-perfusion state, which is the most frequent pathophysiologic event. In this particular setting, the clinical presentation of AMI can be misleading, while the laboratory and radiological diagnostic tests often produce inconclusive results. The management strategies are controversial, but early treatment is critical for saving lives. Based on the experience of our team, we consider prompt exploratory laparotomy, irrespective of the results of the diagnostic tests, isthe only way to provide objective assessment and adequate treatment, leading to dramatic reduction in the mortality rate.

关键词：心肺旁路手术急性肠系膜缺血死亡率预后

治疗量的对乙酰氨基酚对急性病毒性肝炎严重度标志物的影响

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世界核心医学期刊文摘（胃肠病学分册） 2006年第11期2卷 20-21页

作者： Yaghi C. Honein K. boujaoude J. 纪泛扑 Division of Gastroenterology Htel-Dieu de France Adib Ishac Street Achrafieh Beirut Lebanon

Objectives -Data on the influence of acetaminophen intake on acute viral hepatitis is scarce, but it could play a role in the worsening of this disease. The aim of this study was to determine whether the intake of acetaminophen at therapeutic doses affects the severity of acute viral hepatitis. Methods -This was a prospective study concerning 37 consecutive patients hospitalized for acute viral hepatitis. Acetaminophen consumption and time since last intake were assessed by a questionnaire. Parameters of severity were studied in comparison to time related serum concentrations of acetaminophen. Results -Patients hospitalized for acute viral hepatitis (18 male, 19 female patients) had a mean age of 29.2 ±11.5 years. The causal virus was HAV (n = 23), HBV (n = 7) and other viruses (n = 8). The mean cumulated dose of acetaminophen was 7.7 ±5.65 g. The daily dose did not exceed the therapeutic dosage and the mean was 1.95 ±0.81 g (1-3 g). Patients who received 7.5 g of acetaminophen or more had a lower prothrombin index 52.4 ±30.3%vs 74.2 ±17.2%(P = 0.039), and a lower factor V 54.7 ±33.2%vs 83.3 ±19.6%(P = 0.033). Prothrombin index and bilirubinemia were negatively correlated with time related plasma acetaminophen concentrations. Conclusions -The use of acetaminophen at therapeutic doses was associated with greater alterations of surrogate markers of the severity of acute viral hepatitis especially hepatitis A. This was related to cumulated dosages and correlated to the time related acetaminophen plasma concentrations. Acetaminophen use should be interrupted when acute hepatitis is suspected.

关键词：急性病毒性肝炎乙酰氨基酚严重度凝血酶原指数血清浓度急性肝炎致病病毒胆红素血症浆浓度