Pierre Hoang

Is early enteral nutrition in acute pancreatitis dangerous? About 20 patients fed by an endoscopically placed nasogastrojejunal tube.

Bowel rest during treatment of acute pancreatitis deprives the gut of nutrients and affects its structure and function. Enteral feeding is usually performed late in the course of acute pancreatitis and therefore cannot prevent intestinal barrier dysfunction and possible bacterial translocation. To assess the effect of early enteral nutrition we performed a prospective study on 21 patients (11 males/10 females) presenting with severe acute pancreatitis (13 biliary, 6 alcoholic, and 2 miscellaneous). Severity was established by a mean Ranson score of 3.57. All but one patient could be fed through a double-lumen nasogastrojejunal tube within 60 h after admission. No significant complication of the technique was observed. We conclude that early jejunal feeding can be used safely in severe acute pancreatitis. Further comparative studies are necessary to demonstrate any superiority to total parenteral nutrition.

MRI of complicated anal fistulae: comparison with digital examination.

Objectives The assessment of complicated anal fistulae is based on digital examination. Our objective was to study the potential role of MRI in this setting by comparing preoperative digital examination with MRI. Materials and Methods Digital examination and MRI were prospectively and blindly interpreted in 13 patients with complicated anal fistulae. Surgical findings were used as standard. Results Complete agreement between the results of digital examination and the surgical findings was observed in 8 patients and between the results of MRI and the surgical findings in 12 patients. Digital examination misclassified two low transsphincteric fistulae as high transsphincteric and missed high secondary extensions or abscesses in three other patients. Magnetic resonance misclassified only one suprasphincteric fistula as low transsphincteric and did not overlook high secondary extensions or abscesses. Conclusion These findings suggest that MRI may show abnormalities not detected by preoperative digital examination.

Disposable versus reusable biopsy forceps: a prospective cost evaluation

BACKGROUND There is growing advocacy for the use of disposable medical accessories to reduce the risks of infection transmission. Their purchase costs can, however, be considered as prohibitive in an endoscopy unit operating under a cost-containment program. We therefore compared the costs of reusable and disposable biopsy forceps. METHODS From October 1995 to September 1997, biopsies were obtained in 7740 sessions. The evaluation of costs included purchase prices, repairs, cleaning (chemicals, equipment, technician time) and autoclaving costs in a centralized sterilization unit. For comparison, the lowest purchase price for disposable biopsy forceps was

Familial adenomatous polyposis associated with multiple adrenal adenomas in a patient with a rare 3' APC mutation.

26.90 in 1997. RESULTS A mean of 12 new reusable forceps were purchased every year for a total purchase price of

Idiopathic non-familial rectal and colonic varices requiring sigmoidorectal resection and coloanal anastomosis

5460. A total of 315 biopsy sessions were performed per forceps (mean time life of 3 years per forceps, including 3 repairs). Yearly repair cost was

Control of AA amyloidosis complicating Crohn's disease: a clinico-pathological study.

3308, equipment

Human colonic intraepithelial lymphocytes regulate the cytokines produced by lamina propria mononuclear cells.

1002, chemicals

Prognosis of ischemic colitis : Comparison of color Doppler sonography with early clinical and laboratory findings

3250, central sterilization

[Vascular Gastric-lesions, Crest Syndrome and Primary Biliary-cirrhosis - Efficacy of Estrogen-progesterone Treatment]

8333, and technician salary

Focal bowel wall changes detected with colour Doppler ultrasound: diagnostic value in acute non-diverticular diseases of the colon

4373. Total cost was