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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： EUS guided-FNA Pancreatic Tuberculosis

Splenic artery aneurysm presenting as a submucosal gastric lesion: A case report

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World Journal of Gastrointestinal Endoscopy 2016年第14期8卷 496-500页

作者： Jenny Tannoury khalil honein Bassam Abboud Department of Gastroen-terology and Hepatology Hotel Dieu de France Hospital Faculty of Medicine Saint--Joseph University Department of General Surgery Hotel Dieu de France Hospital Faculty of Medicine Saint--Joseph University

We are reporting the rare case of splenic artery aneurysm of 4 cm of diameter presenting as a sub mucosal lesion on gastro-duodenal endoscopy. This aneurysm was treated by endovascular coil embolization and stent graft implantation. The procedure was uneventful. On day 1, the patient presented an acute severe epigastric pain and cardiovascular arrest. Abdominal computed tomography scan showed an active leak of the intravenous contrast dye in the peritoneum from the splenic aneurysm. We performed an emergent resection of the aneurysm, and peritoneal lavage. Postoperatively, hemorrhagic choc was refractory to large volumes replacement, and intravenous vaso-active drugs. On day 2, he presented massive hematochezia. We performed a total colectomy with splenectomy and cholecystectomy for ischemic colitis, with spleen and gallbladder infarction. Despite vaso-active drugs and aggressive treatment with Factor VIIa, the patient died after uncontrolled disseminated intravascular coagulation.

关键词： Gastroscopy Splenic artery aneurysm Rupture Endo-vascular treatment Surgery

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

AIM： To study the epidemiology of HCC in Lebanon and prognostic factors predictive of early mortality. METHODS： An observational follow-up cohort study of HCC cases diagnosed over a five-year period was carried out. Multivariate analysis was conducted to identify prognostic factors in comparison to Cancer of the Liver italian Program （CUP） score. Multiple variables including the etiology of underlying liver disease, the demographic characteristics of patients, and the severity of liver disease evaluated by the Child-Pugh score were studied. Tumor parameters included the time of diagnosis of HCC, alpha-fetoprotein level, number and size of nodules, presence of portal vein thrombosis, and treatment modalities. Death or loss of follow-up was considered as an end-point event. RESULTS： Ninety-two patients （mean 60.5 ± 22.3 years） were included. Etiology of underlying disease was hepatitis B, C, and alcohol in 67%, 20%, and 23.5% respectively. Child-Pugh class at diagnosis was A, B, and C in 34.8%, 39.3% and 25.8% respectively. Overall survival was 44.8%, 32.8% and 17.6% at 1, 2 and 3 years respectively （mean F/U 40.2 ± 23.5 mo）. Multivariate analysis identified three predictors of early mortality （〈 6 mo）： bilirubin 〉 3.2 mg/dL （P 〈 0.01）, HCC as first presentation of liver disease （P = 0.035）, and creatinine 〉 1 mg/dL （P = 0.017）. A score based on these variables outperformed the CLIP score by Cox proportional hazard. ROC curve showed both models to be equivalent and moderately accurate.CONCLUSION： HBV is the leading cause of HCC in Lebanon. Independent predictors of early mortality are elevated bilirubin, creatinine and HCC as first manifestation of disease. Prospective validation of a score based on these clinical parameters in predicting short-term survival is needed.

关键词： Liver Epidemiology Hepatitis Neoplasm Cancer Cirrhosis

Isolated fever induced by mesalamine treatment

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World Journal of Gastroenterology 2013年第7期19卷 1147-1149页

作者： Rita Slim Joseph Amara Roy Nasnas khalil honein Joseph Bou Jaoude Cesar Yaghi Fady Daniel Raymond Sayegh Department of Gastroenterology Hotel Dieu de France University HospitalSaint Joseph University Department of Infectious Diseases Hotel Dieu de France University HospitalSaint Joseph University

Adverse reactions to mesalamine,a treatment used to induce and maintain remission in inflammatory bowel diseases,particularly ulcerative colitis,have been described in the literature as case *** case illustrates an unusual adverse *** patient developed an isolated fever of unexplained etiology,which was found to be related to mesalamine treatment.A 22-year-old patient diagnosed with ulcerative colitis developed a fever with rigors and anorexia 10 d after starting oral mesalamine while his colitis was clinically *** revealed no infection.A mesalamineinduced fever was considered,and treatment was stopped,which led to spontaneous resolution of the *** diagnosis was confirmed by reintroducing the *** year later,this side effect was noticed again in the same patient after he was administered topical *** reaction to mesalamine seems to be idiosyncratic,and the mechanism that induces fever remains *** encountered in the course of a mesalamine treatment in ulcerative colitis must be considered a mesalamine-induced fever when it cannot be explained by the disease activity,an associated extraintestinal manifestation,or an infectious etiology.

关键词： Mesalamine 5-aminosalicylic acid Side effects Adverse reactions Fever