Superior mesenteric artery syndrome-induced pancreatitis: Case report.

Superior mesenteric artery syndrome is an acquired vascular compression disorder resulting from the compression of the third portion of the duodenum, which is the first part of the small intestine, leading to a reduction in the space between the aorta and the superior mesenteric artery. Although rare, superior mesenteric artery syndrome-induced pancreatitis has been documented in the literature. This article presents the case of a 20-year-old female patient with a history of colectomy for acute severe colitis, resulting in significant weight loss. She was admitted to the hospital with symptoms of upper bowel obstruction, and the diagnosis of superior mesenteric artery syndrome complicated by acute pancreatitis was made. The patient underwent a nutritional assistance program along with intravenous fluid therapy, resulting in positive outcomes. Superior mesenteric artery syndrome -induced pancreatitis is rarely reported and can be attributed to an occlusive post-papillary syndrome, which causes retrograde reflux of bile into the pancreatic duct, activating inflammation responsible for pancreatitis.

Hepatic myelopathy neurological complication of chronic liver disease: two case reports.

BACKGROUND: Hepatic myelopathy is a very rare neurological complication of chronic liver disease. Patients habitually present with progressive pure motor spastic paraparesis. This neurological dysfunction is almost always due to cirrhosis and portocaval shunt, either surgical or spontaneous. CASES REPORT: We report two cases of a 57-year-old man and a 37-year-old woman with progressive spastic paraparesis linked to cirrhosis and portal hypertension. The two patients are of Tunisian origin (north Africa). Magnetic resonance imaging of the spinal cord of two patients was normal, while brain magnetic resonance imaging showed a T2 hypersignals of the pallidums. These signs, in favor of hepatic encephalopathy in the two patients with cirrhosis with isolated progressive spastic paraparesis without bladder or sensory disorders, help to retain the diagnosis of hepatic myelopathy. CONCLUSION: Hepatic myelopathy is a severe and debilitating neurological complication of chronic liver disease. The pathogenesis is misunderstood and seems to be multifactorial, including the selective neurotoxic role both of ammonia and other pathogenic neurotoxins. Usually a pathological brain magnetic resonance imaging showing a hepatic encephalopathy was documented, contrasting with a normal spinal cord magnetic resonance imaging that contributed to diagnosis of hepatic myelopathy. Conservative therapies such as ammonia-lowering measures, diet supplementation, antispastic drugs, and endovascular shunt occlusion show little benefit in improving disease symptoms. Liver transplantation performed at early stage can prevent disease progression and could probably allow for recovery.

Tunisian consensus on the management of Helicobacter Pylori infection.

Helicobacter pylori infection is the most common infectious disease worldwide. It is associated with duodenal and gastric ulcer disease and the risk of gastric neoplasia. The management of helicobacter pylori infection currently represents a real challenge for clinicians, given the ever-increasing rate of resistance of Helicobacter pyolori to various antibiotics. In this consensus document, we present recommendations adapted to the Tunisian context, including indications for the detection of helicobacter pylori infection, indications for the use of different diagnostic methods, and a therapeutic strategy for the management of Helicobacter pylori infection.