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Volume 68 - 2005 - Fasc.2 - Original articles

The value of ultrasonography and computerized tomography in estimating the histopathological severity of nonalcoholic steatohepatitis

Background & Aims : Liver biopsy is the gold standard for the diagnosis of non-alcoholic steatohepatitis (NASH), but is an inva- sive method. There is a need for non-invasive methods that can reflect the histopathological severity of NASH. The aim of this study was to compare the ultrasonography and computerized tomography findings with the histopathological severity in patients with NASH. Material and Methods : Twenty-two consecutive patients with biopsy proven NASH and 20 age- and sex-matched healthy indi- viduals were enrolled. Clinical and demographic data were col- lected at the time of liver biopsy. Histopathological grading and staging were made by an expert pathologist. Each patient under- went ultrasonography and computerized tomography. Results : Liver ultrasonographic findings were not correlated with histopathological grade and stage (r : 0.134, P > 0.05 ; r : 0.130, P > 0.05). Mean liver densities obtained by computed tomography of NASH patients were lower than that of controls (P < 0.05) and liver/spleen density ratios were lower than that of controls (P < 0.05). These results were significantly correlated with histopathological grade (r : -0.716, P < 0.001 ; r : -0.663, P : 0.001), but not with the histopathologic stage (r : -0.416, P : 0.05 ; r : -0.356, P : 0.1). Conclusions : Ultrasonography findings do not reflect histo- pathological severity in patients with NASH. Computed tomogra- phy attenuation of the liver is significantly correlated with histopathologic grade but not with histopathological stage. (Acta gastroenterol. belg., 2005, 68, 221-225).


Predictive factors of glucocorticosteroid treatment failure in severe acute idio- pathic colitis

Introduction : The purpose of our study was to determine clini- cal, biological or endoscopic factors that could predict glucocorti- costeroid treatment failure in acute colitis. Patients and Methods : Fifty-four Tunisian Caucasian patients with acute idiopathic colitis (ulcerative colitis in 53 patients, Crohn's colitis in 1 patient) have been evaluated. Non-therapeutic response was defined as over 6 bowel movements per day, blood vis- ible to the naked eye in stools on the fifth day after admission or the development of a complication inducing a resort to surgery. Predic- tive factors were assessed using bivariate and multivariate analysis. Results : Thirty-nine patients (72.2%) had no medical response. In univariate analysis, predictive factors of therapeutic failure were : male sex, tobaccO. previous history of colitis attacks, bowel movements per day over seven at admission and on day three, and pulse rate over 90/mn, temperature over 38°C, systolic blood pres- sure below 11 on day 3 and on day 5 after admission. In multi- variate analysis, bowel movements over seven per day on day 3 of hospitalization and male sex independently predicted a failure of glucorticosteroid treatment. Conclusion : Bowel movements per day over seven on day 3 of hospitalization and male sex were the independently predictive factors of failure of glucocorticosteroid treatment. (Acta gastro- enterol. belg., 2005, 68, 226-229).


Delayed gastric emptying in children with poor appetite

Background : In this study we aimed to evaluate gastric empty- ing time in children with poor appetite. Methods : Anthropometrical measurements, daily energy intakes and gastric emptying times were determined in 36 children with poor appetite. The children were grouped as those with nor- mal and delayed gastric emptying. These groups were then com- pared with respect to age and nutritional status. Results : Malnutrition was found in 63.9% and gastric emptying was delayed in 58.3% of all cases. Children with delayed gastric emptying were significantly older and malnutrition was signifi- cantly higher in this group (7.2 ± 3.1 vs 3.9 ± 1.5 years, P : 0.001 and 81.0% vs 40.0%, P : 0.017, respectively). Daily mean energy intake was significantly lower than daily mean energy require- ment in children with delayed and normal gastric emptying (P = 0.002 and 0.026 respectively). Conclusion : In children with poor appetite, probability of gas- tric motility disorders should be taken into consideration. Especially in children with failure to thrive at preschool and early school years gastric motility studies should be undertaken. (Acta gastroenterol. belg., 2005, 68, 230-232).