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Epidemiological, Clinical, Paraclinical, Etiological and Therapeutic Aspects of Liver Cirrhosis in the Hepato-Gastroenterology Department of the Hospital Aristide Le Dantec in Dakar

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Open Journal of Gastroenterology 2022年第11期12卷 317-323页

作者： Marie Louise Bassène salamata diallo Marieme Polele Fall Mame Aissé Thioubou Téné Sidibé Coumba Cissé Mamadou Ngoné Gueye Department of Gastroenterology and Hepatology Hospital Aristide Le Dantec Dakar Senegal Department of Gastroenterology and Hepatology Peace Hospital Ziguinchor Senegal Department of Gastroenterology and Hepatology Hospital Idrissa Pouye Dakar Senegal

Introduction: Liver cirrhosis is a global public health issue. Our aim was to determine the epidemiological, clinical, paraclinical and therapeutic aspects of liver cirrhosis in the hepato-gastroenterology department of the hospital Aristide Le Dantec in Dakar. Patients and Methods: We conducted a retrospective study with a descriptive focus covering the period from January 1st, 2010 to December 31, 2020. We included the medical records of patients which presented body of clinical and paraclinical arguments which supported the diagnosis of cirrhosis. The data collected were related to age, gender, clinical, paraclinical, therapeutic and prognosis aspects of cirrhosis and were analyzed with the software Sphinx Plus. Results: Prevalence of cirrhosis was 6.2%. Sex ratio was 2.1%. The average age was 38 years. Asthenia (60.9%), altered performance status (60.1%), abdominal pain (37.2%), gastrointestinal bleeding (29.6%) and abdominal swelling (27.8%) were the most common motives of consultation. Physical examination revealed primarily portal hypertension (74.9%), liver failure (2.4%), hepatomegaly (28.2%) and anemia (13.7%). Viral hepatitis B was the most common etiology (81.9%). Abdominal screening (ultrasound/CT scan) showed hepatomegaly (80.6%), liver dysmorphia (87.7%), portal hypertension signs (85.3%) and portal vein thrombosis (18.2%). 55.1% Patients were classified as Child Pugh A, 33.8% were Child Pugh B and 11.1% were Child Pugh C. Tenofovir Disoproxil Fumarate (TDF) was prescribed to all patients affected by hepatitis B virus only. Evolution was characterized by clinical improvement and prognosis reclassification. Conclusion: Liver cirrhosis is a frequent pathology in the hepato-gastroenterology department of the hospital Aristide Le Dantec in Dakar. It affects young male adult. Hepatitis B virus is the leading cause. TDF is an effective treatment.

关键词： Cirrhosis Viral Hepatitis B Portal Hypertension Liver Failure Hepatomegaly

Hepatic Artery Aneurysm: An Unusual Cause of Upper Gastrointestinal Bleed in 49 Years Old Patient

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Open Journal of Gastroenterology 2022年第3期12卷 64-70页

作者： salamata diallo Alioune Badara Fall Mamadou Lamine Gueye Marie Louise Bassene Mamadou Ngoné Gueye Marieme Polele Fall Mame Aissé Thioubou Alsine Yauck Department of Gastroenterology and Hepatology Hospital Aristide Le Dantec Dakar Senegal Department of General Surgery Hospital Aristide Le Dantec Dakar Senegal Department of Gastroenterology and Hepatology Hospital Idrissa Pouye Dakar Senegal Department of Gastroenterology and Hepatology Peace Hospital Ziguinchor Senegal

Hepatic artery aneurysm (HAA) is a rare disease. HAA is generally asymptomatic disease when symptomatic, they usually present with abdominal pain, upper gastrointestinal (GI) bleeding and/or jaundice, hypovolaemia secondary to rupture or GI bleeding with normal GI endoscopy. Surgical repair and endovascular treatment are the two therapeutic options available at present. Case report: A 49-year-old male presented at the emergency department with high gastrointestinal bleeding, abdominal pain and jaundice. Gastroscopy showed an ulcer with flat pigmented haematin on ulcer base (Forrest IIc) that was controlled by medical treatment. CT angiography was done and showed aneurysm of the proper hepatic artery almost totally thrombosed measuring 100 × 59 mm associated with signs of contained rupture. Emergency surgery was indicated. The laparotomy objectified a rupture of the aneurysm in the biliary tree in per operative excision of aneurysm and ligation of the hepatic pedicle was carried out. After surgery, the evolution was favorable with a follow-up of 8 months. Conclusion: HAA rupture is a rare cause of upper GI bleeding. The mortality rate after rupture is relatively high. CT angiography or MRI can diagnose a ruptured of HAA. Urgent surgery should be the first choice in patients with a ruptured HAA with active hemorrhage causing hemorrhagic shock.

关键词： Hepatic Artery Aneurysm Rupture Upper GI Bleeding Surgery

Indications and Results of Lower Gastrointestinal Endoscopy in a Regional Hospital Center in Senegal

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Open Journal of Gastroenterology 2023年第1期13卷 43-48页

作者： Marième Polèle Fall Marie Louise Basséne salamata diallo Mamadou Ngoné Gueye Cheikh Ahamadou Bamba Cissé Madoky Magatte Diop Daouda Dia Mouhamadou Mbengue Department of Gastroenterology and Hepatology Aristide Le Dantec Hospital Dakar Senegal Department of Gastroenterology and Hepatology General Hospital Idrrisa Pouye Dakar Senegal Department of Internal Medecine Regional Hospital Center of Thiès Thiès Senegal

Introduction: Gastrointestinal endoscopy plays a crucial role in the management of gastrointestinal diseases. The aim of this study was to report the indications and results of lower digestive endoscopy in a hospital center in Senegal. Patients and Methods: We conducted a descriptive retrospective study from September 1st, 2017, to September 30, 2018 at the gastrointestinal endoscopy unit of the regional hospital center of Thiès. All patients received for lower gastrointestinal endoscopy and whose reports were usable, were included. In the reports, we collected and analyzed sociodemographic data, indication and results of the endoscopic examination. Results: We included 250 patients. There were 140 men (sex ratio 1.27). The average age was 42 years [range 1 - 92 years]. There were 37 colonoscopies (14.8%), 51 rectosigmoidoscopies (20.4%) and 162 anorectoscopies (64.8%). The patients were from the region of Thiès in 82% of cases. In most cases, they were most often referred by general practitioners (22.8%) and surgeons (20.8%). The main indications were rectal bleeding (36.8%), hemorrhoidal disease (23.2%) and proctalgia (11.6%). Hemorrhoidal disease (63.6%), anal fistula (14%) and tumors (8.8%) were the most common pathologies. Conclusion: Admitted patients at the gastrointestinal endoscopy unit of the regional hospital center of Thiès have many indications as well as pathologies. Anal pathology is dominated by hemorrhoidal disease.

关键词： Lower Gastrointestinal Endoscopy Rectal Bleeding Hemorrhoidal Disease

Clinical Characteristics of COVID-19 Patients with Digestive Symptoms: A Retrospective Study from Dakar, Senegal

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Open Journal of Gastroenterology 2022年第4期12卷 89-97页

作者： salamata diallo Alioune Badara Fall Marie Louise Bassene Mamadou Ngoné Gueye Marieme Polele Fall Mame Aissé Thioubou Alsine Yauck Abdoul Aziz Atteib Fall Atoumane Faye Department of Gastroenterology and Hepatology Hospital Aristide Le Dantec Dakar Senegal Department of Gastroenterology and Hepatology Hospital Idrissa Pouye Dakar Senegal Department of Gastroenterology and Hepatology Peace Hospital Ziguinchor Senegal Department of Internal Medicine Hospital Aristide Le Dantec Dakar Senegal

Introduction: As of February 2022, coronavirus disease 2019 (COVID-19) has caused a pandemic affecting all countries, with a total of 399 million patients and 5 million deaths. The lungs are the major organs involved in COVID-19. COVID-19 infection is not limited to the respiratory system but can affect multiple organs including the gastrointestinal tract. The aim of our study was to assess the prevalence of gastrointestinal (GI) symptoms on admission in patients with COVID-19 and their association with adverse outcomes, including mortality. Methods: In a retrospective study, we examined medical record data from patients with SARS-CoV-2 infection admitted to epidemic treatment center of hospital Aristide Le Dantec, Dakar (Senegal) between May 1, 2020, and June 31, 2021. SARS-CoV-2 infection was diagnosed by real-time polymerase chain reaction on nasopharyngeal and throat swabs. We included all patients with SARS-CoV-2 infection and GI symptoms. Result: The study identified 472 hospitalized patients with confirmed SARS-CoV-2 infection during the study period. We recruited 222 patients with gastrointestinal symptoms. The mean age of patients with GI symptoms was 56 years [17 - 90 years], and 54.9% were male. Patients with GI symptoms had comorbidities in 66.2% of cases. Hypertension, diabetes mellitus and chronic kidney disease were the most common comorbidities at 29.3%, 23.9%, and 6.7%, respectively. Patients with GI had cough in 69.4%, shortness of breath in 61.7%, ageusia in 57.6%, and fever in 53.1%. At presentation among patients with GI symptoms, 32.4% had mild disease, 27.5% had moderate disease, and 40.1% had severe disease. The prevalence of digestive manifestations was 47%, and the main digestive manifestations were nausea (27%), diarrhea (17.1%), abdominal pain (17.1%) and vomiting (14.4%). GI symptoms such as abdominal pain, diarrhea, and vomiting were more common in those with hypertension (45%) and those with diabetes (43%). Conclusion: Gastrointestinal symptoms are common in patients with COVID-19.

关键词： COVID-19 Gastrointestinal Symptoms Senegal

Hepatitis C: Epidemiological, Clinical and Therapeutic Aspects in Dakar (Senegal)

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Open Journal of Gastroenterology 2022年第4期12卷 98-106页

作者： salamata diallo Mariéme Polele Fall Marie Louise Bassène Mamadou Ngoné Gueye Mame Aissé Thioubou Cheikh Ahmadou Bamba Cissé Alioune Badara Fall Abdoul Aziz Atteib Fall Alsine Yauck Cheikh Anta Diop University of Dakar Hospital Aristide Le Dantec Dakar Senegal Cheikh Anta Diop University of Dakar Hospital Idrissa Pouye Dakar Senegal Assane Seck University of Ziguinchor Hospital de la Paix Ziguinchor Senegal

Viral hepatitis C is a major public health problem. The aim of our work was to determine the epidemiological, diagnostic and treatment profiles of patients with HCV in Dakar (Senegal). We conducted a retrospective, descriptive, multicentre study between January 1, 2010, and December 31, 2019. We included 26 patients. The mean age of the patients was 53.5 years [28 - 70 years] and 46.2% were males. Of the 26 patients included, 7 (26.9%) were Senegalese, and the majority were from other African countries. Risk factors for contamination found were surgery in 11 patients (42.3%) and blood transfusion in 1 patient (3.8%). The mean viral load was 6.47 log IU/ml [4.26 - 7.26 log IU/ml]. Ten patients were infected by genotype 4. No patients were co-infected with HIV or HBV. Six patients (23.1% of patients) had significant fibrosis, of which five (19.2% of patients) were in the stage of cirrhosis. Twelve patients (46.2%) started treatment. Eleven were treatment-naïve and 1 did not respond to ribavirin-pegylated interferon-based therapy after 48 weeks. Ten cases of antiviral therapy were based on DAA and ribavirin-pegylated interferon in 2 patients. For the patients treated with peginterferon and ribavirin, a rapid virologic response was observed at 12 weeks in one patient, and the other patient was lost to follow-up. Among DAA-treated patients, 7 had sustained virologic responses at 12 weeks, 2 persisted, and 1 was lost to follow-up. Moderate thrombocytopenia and weight loss were observed in one patient receiving peginterferon and ribavirin. In our study, no patient died on treatment and no patients developed de novo HCC during or after DAA therapy. Conclusion: Viral hepatitis C is rare in Senegal. Despite the progress made in the therapeutic management of viral hepatitis C, it remains a challenge in Senegal. Indeed, DAAs are expensive and are not marketed, which makes them inaccessible to most patients.

关键词： Hepatitis C Epidemiology Diagnosis Treatment Senegal

Acute Pancreatitis during SARS CoV 2 Infection

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Open Journal of Gastroenterology 2023年第1期13卷 28-32页

作者： Marie Louise Bassène Marième Poléle Fall Alioune Badara Fall salamata diallo Coumba Kouba Cissé Téné Sidibé Aï ssé Thioubou Mamadou Ngoné Gueye Hô pital Aristide Le Dantec Avenue Pasteur Dakar Sénégal Hô pital de la Paix Ziguinchor Sénégal Hô pital Général Idrissa Pouye Dakar Sénégal

Introduction: Covid-19 is a systemic disease that can spread to all systems. Among the gastrointestinal manifestations, pancreatic involvement can have a major prognostic impact. We report 3 acute pancreatitis cases occurring during Covid-19, in Dakar. Case 1: 65-year-old woman who presented with intense atypical epigastric pain. Physical examination revealed obesity, high blood pressure and abdominal tenderness. Biological tests found increase CRP (134 mg/l) and lipasemia (312 UI/l). Abdominal CT scan showed findings of Balthazar grade C acute pancreatitis. RT-PCR for SARS CoV 2 RT-PCR was positive. The outcome was favorable. Case 2: 56-year-old woman patient with history of nephroangiosclerosis who presented with dyspnea, cough, fever and moderate epigastric pain. Physical examination revealed epigastric tenderness, high blood pressure, anuria. Biological testing, noted increase CRP (96 mg/l), lipasemia (793 UI/l), creatinine (227 mg/l) and urea (3.84 g/l). Abdominal CT scan showed acute edematous pancreatitis findings. SARS CoV 2 RT PCR was positive. The outcome was favorable. Case 3: 27-year-old man who presented with physical asthenia, headache, and epigastric pain. Physical examination found epigastric tenderness. Elevated CRP level was of 102 mg/l and lipasemia level was of 427 UI/l (7N). Abdominal CT scan showed acute edematous pancreatitis findings. SARS CoV 2 RT PCR was positive. The outcome was favorable. Conclusion: Acute pancreatitis can occur during Covid-19 infection. However, the imputability to the Covid-19 disease necessitates to rule out the most common causes.

关键词： Acute Pancreatitis SARS CoV 2 Covid-19

Benign Stenosis of Oesophagus: About 101 Cases in the Digestive Endoscopy Department of the General Idrissa Pouye Hospital (Dakar, Senegal)

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Open Journal of Gastroenterology 2022年第1期12卷 19-26页

作者： Mamadou Ngoné Guèye Mame Anta Camara Gnagna Diouf salamata diallo Cheikh Ahmadou Bamba Cissé Marème Polèle Fall Mame Aïssé Thioubou Marie Louise Bassène Daouda Dial Mouhamadou Mbengue Hepato-Gastroenterology Department The Idrissa Pouye General Hospital Dakar Senegal Hepato-Gastroenterology Department The Aristide Ledantec Hospital Dakar Senegal Hepato-Gastroenterology Department The Ziguinchor Peace Hospital Dakar Senegal

Introduction: Benign oesophageal strictures are defined as narrowing of the oesophageal lumen not related to neoplastic pathology. They are frequently encountered during endoscopic practice and are often responsible for a reduction in the quality of life of patients due to the appearance of dysphagia. In sub-Saharan Africa, little data are available on these benign esophageal strictures. The objective of our study was to determine the sociodemographic, diagnostic and therapeutic aspects of benign oesophageal strictures in a digestive endoscopy centre in Senegal. Patients and Methods: This was a retrospective, descriptive study analysing reports of upper GI endoscopies performed between January 2015 and December 2017 in a hospital in Senegal. Reports that concluded to have non-neoplastic oesophageal stenosis were collated. Sociodemographic data, indications for and results of endoscopy, and therapeutic modalities were collected. These data were analysed using the Sphinx version 5 software. Results: We collected 101 cases of benign oesophageal stenosis, representing a prevalence of 2.1% in the endoscopy centre. The mean age of the patients was 34 years (range 2 and 83 years) with a median of 37.9 years. There was a female predominance with a sex ratio of 0.38 (73 females). Dysphagia, the main symptom, was present in 87 patients (86

Gastric Polyps in a Digestive Endoscopy Center in Dakar

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Open Journal of Gastroenterology 2017年第10期7卷 279-286页

作者： Marie Louise Bassene salamata diallo Mame Aisse Thioubou Aichetou diallo Mamadou Ngone Gueye Mamadou Lamine Diouf The Department of Hepato-Gastroenterology Aristide Le Dantec HospitalDakarSenegal The Department of Hepato-Gastroenterology General Hospital of Grand YoffDakarSenegal

Introduction: The gastric polyp is a tumor protruding into the gastric lumen. It is asymptomatic most often with a risk of malignant degeneration closely related to its histological nature. These data are very rare in Africa. Objectives: Reporting the frequency and endoscopic and histological characteristics of gastric polyps in the digestive endoscopy center of Aristide Le Dantec hospital in Dakar. Patients and methods: This was a retrospective study carried out in the digestive endoscopy center of Aristide Le Dantec Hospital in Dakar from January 2012 to December 2016. We have included all patients with one or more gastric polyps coupled with histological findings available. Results: There were 60 patients with gastric polyps, hence a prevalence of 0.8%. We included 37 patients. Their mean age was 46 years [21 years - 75 years]. The sex-ratio was 0.48. Epigastralgia was the most frequent endoscopic indication (51.3%). The polyp was unique in 26 patients (70.3%) with an average size of 6.87 mm [2 - 15 mm]. Polyps were sessile in 31 cases (83.8%) and pediculate in 6 cases (16.2%). They were most often in the antrum (51.4%). Antral erosions (13.5%) and fundic atrophy (13.5%) were the main associated endoscopic lesions. These were hyperplastic polyps in 27% of cases and adenoma in 16.2% of cases. Chronic atrophic gastritis (10.8%) and intestinal metaplasia (10.8%) were the main histological lesions associated with polyps. Helicobacter pylori (Hp) were present in 17 patients (45.9%). Conclusion: The prevalence of gastric polyps is 0.8% in the endoscopy center of Aristide Le Dantec hospital. They are usually hyperplastic or adenomatous.

关键词： Gastric Polyps Gastric Hyperplastic Polyps Gastric Adenoma Sub-Saharan Africa

Evaluation of Three <i>Helicobacter pylori</i>Eradication Protocols in a Digestive Endoscopy Center in Dakar

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Open Journal of Gastroenterology 2021年第11期11卷 244-254页

作者： salamata diallo Marie Louise Bassène Marieme Polele Fall Alia Issa Mame Aisse Thioubou Department of Gastroenterology and Hepatology Hospital Aristide Le Dantec Dakar Senegal Department of Gastroenterology and Hepatology Hospital de la Paix Ziguinchor Senegal

Introduction: The treatment of Helicobacter pylori (H. pylori) requires the combination of antibiotic therapy with an antisecretory agent. Due to increasing antibiotic resistance, which varies from one geographical region to another, several eradication protocols exist. Objective: The objective is evaluate and compare the efficacy of three treatment regimens for H. pylori infection: 1) Arm A: Omeprazole + Amoxicillin + Clarithromycin for 10 days;2) Arm B: Omeprazole + Amoxicillin + Metronidazole for 10 days;3) Arm C: Sequential treatment = Omeprazole + Amoxicillin for 5 days then Omeprazole + Clarithromycin + Metronidazole for 5 days. Patients and Method: This was a prospective randomised study conducted from February 2016 to July 2016 and from April 2017 to September 2017 in the digestive endoscopy center of the gastroenterology and hepatology department of the University Hospital Center Aristide Le Dantec. Our study population consisted of all patients aged 18 years or older referred for upper GI endoscopy. We included all patients whose indication for the examination was epigastralgia and/or dyspepsia and whose rapid urease test was positive. Patients were randomized to the different treatment arms. A 13C-urea breath test was performed at least 4 weeks after stopping antibiotics and 2 weeks after stopping proton pump inhibitor (PPI). Results: We included 120 patients. There were 95 women and 25 men. The mean age was 40 years. Epigastralgia and dyspepsia were present in 90% and 59% of cases, respectively. Upper GI endoscopy showed peptic ulcer in 19.2% and gas

关键词： Helicobacter pylori Epigastralgia Dyspepsia Antibiotics Resistances