INITIAL MANAGEMENT IN ACUTE PANCREATITIS

peer reviewedBasic steps of acute pancreatitis initial management are diagnostic assessment, severity prediction, search for concomitant abnormalities being part of the etiologic work up or requiring an early treatment. Adequate volume perfusion is certainly the most important therapeutic measure

Prise en charge de l'angiocholite

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Approche diagnostique d’une angiocholite

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Endorectal Ultrasound in Infectious Colitis May Predict Development of Chronic Colitis

BACKGROUND AND STUDY AIMS: In a previous study, we have shown that rectal endoscopic ultrasound (EUS) could be used to differentiate ulcerative colitis from Crohn's disease by demonstrating the presence of pathological lymph nodes around the rectum and sigmoid colon which were characteristic of ulcerative colitis. The aim of the present study was to evaluate the endosonographic features of infectious colitis and their potential clinical relevance. PATIENTS AND METHODS: We carried out rectal endosonography in 17 patients with infectious colitis of various etiologies. Wall features and perirectal lymph nodes were documented systematically. RESULTS: In 15 patients no pathological lymph nodes were seen and the EUS wall features were also normal. In two patients where EUS showed pathological lymph nodes, follow-up confirmed ulcerative colitis several weeks later. CONCLUSIONS: This preliminary study suggests that, in patients with infectious colitis, EUS may be able to suggest the diagnosis of associated ulcerative colitis; further studies with larger patient numbers are necessary

Critical assessment of long-term proton pump inhibitor use in the elderly

Proton pump inhibitors (PPI) are drugs frequently used for gastric acid-induced conditions. Their use is constantly increasing and due to the apparent absence of side-effects, the treatment is not reassessed, even for the elderly. However, there are many cases of misprescribing while concerns about some side-effects are rising. Old people are weakened by their particular homeostasis and their associated medical conditions. Therefore, it seems useful to particularly insist on side-effects of the PPI, their indications and the ways of withdrawal, first of all for the elderly

Pharma Clinics. How I Diagnose and Treat...Stress Ulcers

peer reviewedStress related ulcers are superficial and extensive gastric mucosal lesions. They occur in almost all critically ill patients but lead to gastrointestinal bleedings in only 5 to 10%. Endoscopy permits definitive diagnostic. Stress related mucosal diseases encount for substantial morbidity and mortality. The preventive therapeutic choice depends on efficacy, side effects as cost and nosocomial pneumonia. Sulcralfate appears to be the best choice because of its lower cost, comparable efficacy (sucralfate versus anti-H2) and its lower risk of inducing nosocomial pneumonia. Patients who greatly benefit from prevention, present respiratory failure with at least 48 hours mechanical ventilation, coagulopathy, sepsis or burns. Global management avoiding hypoxia, hypotension and acidosis, takes an important part in the prevention

Comment je préviens et je traite : les ulcères de stress

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Therapeutic Alternatives in Crohn Disease and in Ulcero-Hemorrhagic Rectocolitis: Current Findings

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