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Prediction,prevention and management of gastroesophageal reflux after per-oral endoscopic myotomy:An update

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World Journal of gastroenterology 2024年第9期30卷 1096-1107页

作者： Zaheer Nabi Pradev Inavolu Nageshwar Reddy Duvvuru department of gastroenterology Asian Institute of GastroenterologyHyderabad 500082TelanganaIndia department of Medical gastroenterology Asian Institute of GastroenterologyHyderabad 500032TelanganaIndia

Achalasia cardia,the most prevalent primary esophageal motility disorder,is predominantly characterized by symptoms of dysphagia and *** principal therapeutic approaches for achalasia encompass pneumatic dilatation(PD),Heller's myotomy,and the more recent per-oral endoscopic myotomy(POEM).POEM has been substantiated as a safe and efficacious modality for the management of *** POEM demonstrates superior efficacy compared to PD and an efficacy parallel to Heller's myotomy,the incidence of gastroesophageal reflux disease(GERD)following POEM is notably higher than with the aforementioned *** symptomatic reflux post-POEM is relatively infrequent,the significant occurrence of erosive esophagitis and heightened esophageal acid exposure necessitates vigilant monitoring to preclude long-term GERD-related *** advancements in the field have enhanced our comprehension of the risk factors,diagnostic methodologies,preventative strategies,and therapeutic management of GERD subsequent to *** review focuses on the limitations inherent in the 24-h pH study for evaluating post-POEM reflux,potential modifications in the POEM technique to mitigate GERD risk,and the strategies for managing reflux following POEM.

关键词： Achalasia cardia Per-oral endoscopic myotomy Gastroesophageal reflux Esophagitis Gastroesophageal reflux disease

Serological Profile of Hepatitis D Virus (Hepatitis Delta) in the hepato-Gastro-Enterology department of Chu Gabriel Toure

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Open Journal of gastroenterology 2024年第3期14卷 93-98页

作者： Sanra Déborah Sanogo Kadiatou Doumbia Hourouma Sow Moussa Younoussou Dicko Youssouf Oumarou Abdoulaye Berthé Sabine Drabo Luc Sidibé Makan Siré Tounkara Abdoulaye Maiga Ouatou Mallé Ganda Soumaré Anselme Konaté Moussa Tièmoko Diarra hepato-gastroenterology department CHU Point G Bamako Mali hepato-gastroenterology department CHU Gabriel Touré Bamako Mali department of Internal Medicine Centre Hospitalier Universitaire Communautaire de Bangui Bangui Central African Republic

Infection with the defective hepatitis D virus (HDV) co-infects or superinfects a patient carrying hepatitis B virus (HBV). Delta virus infection is relatively common. The seriousness of infection with the hepatitis D virus (HDV), a virus defective in a patient carrying the hepatitis B virus (HBV), lies in its aggravating effect on the associated viral hepatitis B. Our aim was to study the serological profile of HDV in HBsAg-positive patients. As this study was fragmentary, we initiated this study with the aim of investigating the serological profile of HDV in HBsAg-positive patients. This was a descriptive and analytical cross-sectional study that ran from March 2019 to February 2020, a 12-month period. It focused on the population of patients seen and screened positive for HBsAg. We obtained a frequency of 10%. The mean age of our patients was 41.8 ± 13.09 years. The sex ratio was 4.5. VHD RNA was detected in 50% of patients. In 100% of cases, the presence of VHD RNA was associated with advanced fibrosis according to the APRI score, but without any statistically significant link. All HBV-infected patients should be screened for anti-HDV Ac. HDV infection leads to rapid progression to complications of liver disease.

关键词： HBsAg VHD RNA Liver Disease

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

Risk Factors Recurrence of Spontaneous Ascitic Fluid Infection (Slai) in Cirrhotic Patients

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Open Journal of gastroenterology 2024年第8期14卷 249-260页

作者： Diallo Mamadou Sarifou Ottou Onana Christian Lionel Soro Dramane Youssouf Oumarou Yaogo Abdoulatif Lohoues-Kouacou Marie Jeanne hepato-gastroenterology department The Donka National Hospital Conakry Guinea Faculty of Health Sciences and Techniques Gamal Abdel Nasser University Conakry Guinea hepato gastroenterology department Cocody University Hospital Abidjan Ivory Coast Community University Hospital Center of Bangui Internal Medicine Department Bangui African hepato gastroenterology department Angr University Hospital Abidjan Ivory Coast

Introduction: After an episode of spontaneous infection of ascitic fluid (ISLA). The recurrence of ISLA at one year is greater than 70%. We studied the risk factors associated with the occurrence of recurrence. Patients and methods: this was a retrospective, descriptive and analytical study of patient files, hospitalized in the department for 12 months, the choice of the sample was of convenience. Results: We have 1347 patient files collected including 389 cases of cirrhosis. We had 37 files of cirrhotic patients with ISLA including 28 cures without recurrence of ISLA, 08 files of patients with recurrence of ISLA and 03 excluded, i.e. a hospital prevalence of recurrence of 0.6% and a prevalence in cirrhotic patients of 23.5%. The most common antecedents were: hospital contact recent (35.3%), the concept of iterative ascites punctures (32.3%), the presence of HCC (29.4%), hepatic encephalopathy (20.6%) and digestive hemorrhage (14.7%). In univariate analysis, recent digestive bleeding was associated with an increased risk of recurrence (OR 7.2, 95% CI 0.96 - 67.1). HBV (62.5%) is the main etiology of cirrhosis. The PNN rate at 250 - 499 mm3 (62.5%), the protein level 3 (75%). Patients on secondary prophylaxis with NORFLOXACIN were 25%. Recurrence of ISLA was treated with CEFTRIAXONE 2 g/24 hours. Conclusion: Recurrence of ISLA is serious, the predictive factors for recurrence are, hospital contact recent, the concept of iterative ascites punctures, the presence of HCC, the presence of hepatic encephalopathy and digestive bleeding.

关键词： Antibiotic Cirrhosis Risk factors Spontaneous Ascitic Fluid Infection Recurrence

Anal Pathologies: What Management at the Reference Health Center of Bamako’s Commune V?

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Open Journal of gastroenterology 2024年第3期14卷 87-92页

作者： Sanra Déborah Sanogo Moussa Y. Dicko Ousmane Diarra Abou A. Diarra Drissa Katilé Abdoulaye Maiga Ouatou Mallé Sabine Drabo Makan S. Tounkara Hourouma Sow Kadiatou Doumbia Anselme Konaté Moussa T. Diarra hepato-gastroenterology department CHU Point G Bamako Mali Service d’hépato-gastroentérologie CHU Gabriel Touré Bamako Mali hepato-gastroenterology Unit CSREF Commune V Bamako Mali

Anal pathologies are conditions affecting the anal margin and the anal canal. The aim of our study was to update data on anal diseases. Non-specific, it can reveal an emergency, a serious illness, a chronic disease or a benign condition. It was a prospective, descriptive and analytical study from April 2022 to March 2023, carried out in the hepato-gastroenterology unit of the Centre de Santé de Référence de la commune V du District de Bamako in Mali. Out of seven hundred and forty-nine (749) patients seen in consultation, 98 had anal pathology, i.e. a prevalence of 13.08%. The mean age was 40 ± 15.15 years and the sex ratio was 1.5. Hemorrhoidal disease and anal fissure were the most frequent pathologies in 66.4% and 24.4% of cases respectively. Medical treatment was initiated in 91.9% of patients with hemorrhoidal disease and 91.7% with anal fissure. Anal pathologies are common in young male patients. In our context, they are dominated by benign conditions.

关键词： Anal Pathologies Hemorrhoidal Disease Anal Fissure

Vonoprazan-amoxicillin dual therapy for Helicobacter pylori eradication in Chinese population:A prospective,multicenter,randomized,two-stage study

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World Journal of gastroenterology 2024年第27期30卷 3304-3313页

作者： Xue-Ping Huang Zhi-Hui Lin Yi-Juan Liu Shao-Wei Lin Yan-Feng Shao Feng Qiu Qing-Wu Qiu Zhang-Kun Xu Jin-Xian Chen Liang-Huo Chen Zhen-Qun Lin Wen-Hua Dai Ming-Qing Zhang Qi Jiang Zhong-Qin Xiao Xian-Xing Cheng Xiang-Fei Zhang Wen-Bin You Wei Chen Long-Qin Li Wei-Xing Lin Yong-Fu Wang Fu-Jin Lai Long-Qun Chen Zhong-Hua Huang Wen-Qi Zheng Jin-Qi Wei department of gastroenterology Shengli Clinical Medical College of Fujian Medical UniversityFuzhou 350000Fujian ProvinceChina department of gastroenterology Fujian Provincial HospitalFuzhou 350001Fujian ProvinceChina department of gastroenterology The First Affiliated Hospital of Fujian Medical UniversityFuzhou 350000Fujian ProvinceChina School of Public Health Fujian Medical UniversityFuzhou 350000Fujian ProvinceChina department of gastroenterology The Third People’s Hospital of Fujian ProvinceFuzhou 350000Fujian ProvinceChina department of gastroenterology Fujian Provincial Hospital North Brance Fujian Provincial Geriatric HospitalFuzhou 350000Fujian ProvinceChina department of gastroenterology Xiaoao HospitalFuzhou 350000Fujian ProvinceChina department of gastroenterology The General Hospital of Fujian Energy GroupFuzhou 350000Fujian ProvinceChina department of gastroenterology The Second Hospital of ZhangzhouZhangzhou 363000Fujian ProvinceChina department of gastroenterology Anxi Country HospitalQuanzhou 362000Fujian ProvinceChina department of gastroenterology Zhangzhou Municipal Hospital of TCMZhangzhou 363000Fujian ProvinceChina department of gastroenterology Zhangpu HospitalZhangzhou 363000Fujian ProvinceChina department of gastroenterology The Affiliated Dongnan Hospital of Xiamen UniversityZhangzhou 363000Fujian ProvinceChina department of gastroenterology First Hospital of Nanping CityNanping 353000Fujian ProvinceChina department of gastroenterology Fujian Nanping Second HospitalNanping 353000Fujian ProvinceChina department of gastroenterology Wuyishan Municipal HospitalNanping 353000Fujian ProvinceChina department of gastroenterology Fuzhou Changle District HospitalFuzhou 350000Fujian ProvinceChina department of gastroenterology Changle City Second HospitalFuzhou 350000Fujian ProvinceChina department of gastroenterology Jinjiang Municipal HospitalQuanzhou 362000Fujian ProvinceChina department of gastroenterology Fuding Hospital Affiliated to Fuj

BACKGROUND The efficacy of Vonoprazan-amoxicillin dual therapy(VAT)in the treatment of Helicobacter pylori(***)is *** To evaluate the efficacy of VAT in the Chinese *** This prospective,multicenter,randomized,open-label,and two-stage study was conducted at 23 centers in Fujian,China(May 2021-April 2022).***-infected patients were randomized to bismuth quadruple therapy(BQT),BQT-Vonoprazan(BQT-V),seven-day VAT(VAT-7),ten-day VAT(VAT-10),and fourteen-day VAT(VAT-14)*** primary endpoint was the *** eradication *** secondary endpoint was the frequency of adverse *** study was registered with the Chinese Clinical Trial Registry,*** In the first stage,VAT-7 and BQT-V groups were selected for early termination because less than 23 among 28 cases were *** the second stage,the eradication rates for BQT,VAT-10,and VA-14 were 80.2%[95%confidence interval(95%CI):71.4%-86.8%],93.2%(86.6%-96.7%),92.2%(85.3%-96.0%)in the intention-to-treat(ITT)analysis,and 80.9%(95%CI:71.7%-87.5%),94.0%(87.5%-97.2%),and 93.9%(87.4%-97.2%)in the per-protocol *** ITT analysis showed a higher eradication rate in the VAT-10 and VAT-14 groups than in the BQT group(P=0.022 and P=0.046,respectively).The incidence of adverse events in the VAT-10 and VAT-14 groups was lower than in the BQT group(25.27%and 13.73%vs 37.62%,respectively;P<0.001).CONCLUSION VAT with a duration of 10 or 14 days achieves a higher eradication rate than the BQT,with a more tolerable safety profile in ***-infected patients in *** XP et *** for *** eradication.

关键词： Helicobacter pylori Vonoprazan Amoxicillin Dual therapy Bismuth quadruple therapy

A BBS4 mutation causes autosomal dominant polycystic liver disease

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Genes & Diseases 2024年第1期11卷 72-75页

作者： Yalu Cui Wenping Xu Jinpei Liu Shuqing Liu Wei Huang Yihai Shi Xin Zhang Cuihua Lu Weifen Xie department of gastroenterology Changzheng HospitalNaval Medical UniversityShanghai 200003China department of gastroenterology Gongli Hospital of Shanghai Pudong New AreaShanghai 200135China department of gastroenterology Affiliated Hospital of Nantong UniversityNantong UniversityNantongJiangsu 226001China

Autosomal dominant polycystic liver disease(ADPLD)refers to a condition characterized by the presence of numerous cholangiocytes-lined and fluid-filled cysts in the liver and the absence of polycystic kidney disease.1 Although patients with ADPLD may be asymptomatic,some patients suffer from abdominal pain,gastroesophageal reflux,and nausea,because of hepatomegaly.

关键词： liver polycystic patients

Hepatic Elastometry in the Management of Hepatitis B at National Hospital of Niamey

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Open Journal of gastroenterology 2024年第9期14卷 313-321页

作者： Ousseini Fanta Hamidine Illa Moussa Saley Sahada Abdourahamane Idrissa Fatouma Abdou Nafissatou Ali Cheik Rakia Abdou Boubé Abdou Djibo Ben Moctar Ky Lawagoulé Joseph Emile Daou Mamane Faculty of Health Sciences Abdou Moumouni University Niamey Niger department of hepato-gastroenterology National Hospital of Niamey Niamey Niger Laboratoire de Recherche Clinique et Systme de Sant Niger Universit Andr Salifou of Zinder Zinder Niger department of hepato-gastroenterology Zinder National Hospital Zinder Niger department of Infectiology National Hospital of Niamey Niamey Niger Regional Hospital Centre of Niamey Niamey Niger department of hepato-gastroenterology General Reference Hospital of Niamey Niamey Niger department of hepato-gastroenterology The University Hospital Ouagadougou Burkina Faso department of Internal Medicine General Reference Hospital of Niamey Niamey Niger

Introduction: Viral hepatitis B is a public health problem in Niger which is classified as a high endemicity area with a prevalence ranging from 8 to 17% depending on the studies [1] and that of HBV-related cirrhosis is about 40.26% in 2024. The decision to treat is based on a combination of three parameters: viral load, ALT values and the degree of hepatic fibrosis [2]. The latter is assessed by hepatic elastography (Fibroscan), which is a decisive factor in treatment. In Niger, until 2024, the decision to treat or not to treat a patient with HBV was based on the determination of viral load B and transaminases, and no work evaluating the contribution of this third element, liver elasticity, has been done, hence the interest of our study. Objective: To study the contribution of Fibroscan in measuring hepatic elasticity in the management of patients with HBV. Methodology: This was a prospective descriptive study conducted from January 05 to November 30, i.e. a period of 11 months, on clinically asymptomatic HBsAg-positive patients who had undergone FibroScan liver elasticity measurement. The examination was carried out by a hepatogastroenterologist who had received training in the Fibroscan. The median of ten measures of liver elasticity at the same point with an IQR of less than 30% was considered the valid measure and no or minimal fibrosis was defined as a value ˂7 Kpa, moderate fibrosis as a value between 7 and 10 kpa, severe fibrosis as a value greater than 10 Kpa, and the existence of cirrhosis as a value greater than 14 Kpa were analyzed using SPSS version 20 software. Results: Out of 398 patients monitored for HBV, 60 cases met the inclusion criteria, i.e., a frequency of 15.07%. The mean age of the patients was 35.63 years, with extremes of 18 and 70 years. They were predominantly male, with a sex ratio of 3.2. Married patients accounted for 61.67% (n = 37). Jaundice was absent in 91.67% (n = 55). The circumstances of discovery of HBV were the routine health

关键词： Hepatic Elasticity Fibroscan Fibrosis Hepatitis B Niger

Case Report: Autoimmune Pancreatitis: About a Case in hepato-gastroenterology department of Mother-Child Hospital in Bamako/Mali

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Health 2020年第10期12卷 1379-1382页

作者： Sanra Déborah Sanogo Moussa Y. Dicko Ganda Soumaré Kadiatou Doumbia Hourouma Sow Makan S. Tounkara Youssouf Kassambara Hamadoun Guindo A. Maiga A. Kondé Abdoulaye Diarra Ilias Guindo Drissa Katilé Ouatou Mallé Anselme Konate Moussa T. Diarra Bougouzié Sanogo Moussa Y. Maiga gastroenterology department Point G University Hospital Bamako Mali gastroenterology department Gabriel Touré University Hospital Bamako Mali gastroenterology department Mother-Child Hospital Bamako Mali Surgery department BSS University Hospital Bamako Mali

Autoimmune pancreatitis is a distinct form of chronic pancreatitis. It is a chronic pancreatitis distinct from alcohol, genetic or idiopathic impairment and involves possible autoimmune mechanisms. The diagnosis of autoimmune pancreatitis is based on a body of biological, histological and radiological arguments. Also called sclerosing lymphoplasmacytic pancreatitis, it is one of the causes of chronic pancreatitis. The risk factor for the onset of cancer that it represents and its sensitivity to corticosteroids make it a pathology requiring special management. We report a case of autoimmune pancreatitis in a 35-year-old patient.

关键词： Autoimmune Pancreatitis Young Woman Diagnosis Mali