Chronic gastric volvulus.

Gastric volvulus is an abnormal rotation of the stomach around his axis. The chronic presenting, as the acute one, is considered as a surgical emergency. We report 4 cases of chronic gastic volvulus. In 2 cases, it was a mesenterico-axial volvulus while in the 2 other cases it was an organo-axial volvulus. The barium enema made the diagnosis in all cases. The volvulus was secondary to a hernia in 3 cases and an agenesis of left diaphragmatic dome with ligament laxity in 1 case. All the patients underwent surgery. The laparoscopic approach was used in two patients.

Sclerosing Cholangitis in Behçet's Disease.

Introduction. Sclerosing cholangitis is characterized by an inflammatory and fibrotic lesion of intra- and/or extrahepatic bile ducts. When a causal mechanism of a bile duct lesion is identified, the sclerosing cholangitis is considered secondary. The vasculitis, including the Behçet disease, is cited as a probable cause of the ischemia and the sclerosing cholangitis. No cases of extrahepatic secondary sclerosing cholangitis have been reported to date. Case Report. We report the first case of secondary sclerosing cholangitis of the extrahepatic bile ducts associated with Behçet disease in a male who is aged 43, with a previous history of the angio-Behçet followed by complications of thrombophlebitis and a cerebral thrombophlebitis, and who has a cholestatic jaundice. The diagnosis has been carried out by the MR cholangiopancreatography which has objectified a moderate distension of the intrahepatic bile ducts upstream of regular stacked parietal thickening of the main bile duct. The patient has been treated successfully with the ursodeoxycholic acid and the placement of a plastic stent. Conclusion. This diagnosis should be mentioned to any patient with vasculitis and who has a cholestatic jaundice.

[Hepatic steatosis in chronic hepatitis B: prevalence, risk factors, and impact on fibrosis and therapeutic response]. / La stéatose hépatique au cours de l'hépatite chronique B: prévalence, facteurs de risque, et effet sur la fibrose et la réponse thérapeutique.

BACKGROUND: steatosis is a common injury in chronic hepatitis C, but this association has not been sufficiently studied in chronic hepatitis B. aim: To evaluate the prevalence of hepatic steatosis in chronic hepatitis B and determine its association with various histologic, biochemical, virological, and metabolic diseases, and its effect on fibrosis and therapeutic response. METHODS: Our study was compiled 133 patients with chronic hepatitis B who received no antiviral therapy and who had a liver biopsy. Our patients were divided into 2 groups: 51 patients (38.3%) had steatosis (Group I), while 82 (61.7%) had no steatosis (Group II). RESULTS: In groupeI, the average age, BMI, cholesterol, triglycerides, and glucose were significantly higher than the group without steatosis in univariate study (P <0.05). In multivariate analysis, only high BMI and hypertriglyceridemia were included.No significant difference between the two groups was observed in the rate of transaminases, HBeAg status, viral load (P> 0.05). Steatosis doesn't influence fibrosis stage and therapeutic response. CONCLUSION: During chronic hepatitis B, steatosis appears to be the result of metabolic factors of the host rather than the effect of the virus. Hepatic steatosis does not seem to influence the progression of liver fibrosis, or therapeutic response, however, the role of steatosis should be better studied by prospective longitudinal clinical studies on large populations of patients.