clove and Gastrointestinal-Hemorrhage

Peutz-Jeghers syndrome (SPJ) is characterized by intestinal hamartomatous polyps in association with mucocutaneous lentiginosis. Patients are exposed to mechanical and bleeding complications. It is a cancer predisposition syndrome. Our study highlights the diagnostic criteria for Peutz-Jeghers syndrome (SPJ), the complications and the therapeutic progresses in patient care. We report the case of a 32-year-old male presenting with a massive melaena. It was hospitalized in the surgical intensive care unit with hypovolemic shock difficult to control. This required surgical intervention to stop bleeding. We found a hamartomatous polyps in the small intestine which caused bleeding. Peutz Jeghers Syndrome was diagnosed on the basis of labial lentigines during childhood. Clinical and paraclinical explorations did not reveal the presence of cancer. In Madagascar, this disease is still poorly understood. In the literature, the diagnosis of Peutz Jeghers syndrome is based on clinical findings or on the presence of complications such as haemorrhage, invagination or bowel obstruction. In our case, the disease was complicated by gastrointestinal bleeding with hypovolemic shock. Endoscopic polypectomy using double-balloon enteroscopy can reduce emergency small bowel surgery. Peutz-Jeghers syndrome is a rare disease. Despite this, it is important for clinicians to know it and to take it into consideration in case of gastrointestinal bleeding.

Topics: Adult; Endoscopy, Gastrointestinal; Gastrointestinal Hemorrhage; Hamartoma; Humans; Intestinal Polyps; Madagascar; Male; Melena; Peutz-Jeghers Syndrome; Shock

Topics: Animals; Denmark; Gastrointestinal Hemorrhage; Humans; Madagascar; Male; Middle Aged; Rectum; Schistosoma haematobium; Schistosomiasis haematobia; Yemen

Topics: Adolescent; Adult; Age Distribution; Aged; Aged, 80 and over; Critical Care; Female; Gastrointestinal Hemorrhage; Hemostatic Disorders; Hospitals, University; Humans; Incidence; International Normalized Ratio; Madagascar; Male; Middle Aged; Partial Thromboplastin Time; Prothrombin Time; Retrospective Studies; Sex Distribution; Young Adult

Topics: Adult; Aged; Blood Transfusion; Female; Gastrointestinal Hemorrhage; Hospitals, Teaching; Humans; Madagascar; Male; Middle Aged; Predictive Value of Tests; Prognosis; Research Design; Survival Analysis

Cirrhotic patients have poorer life expectancy than the general population. The purpose of this study was to identify causes of death in a sample of cirrhotic patients from Madagascar.. A retrospective analytic and descriptive study was conducted on the files of cirrhotic inpatients admitted to the gastroenterology department of the Joseph Raseta Befelatanana University Hospital Center in Antananarivo, Madagascar from January 1, 2003 to June 30, 2007.. The files of 117 patients were reviewed. Death occurred in 31 cases for a mortality rate of 26.5%. The main causes of death were disorders of consciousness (51.6%) and hypovolemic shock (25.8%). Jaundice, encephalopathy, and gastrointestinal bleeding were predictive factors for mortality.. Cirrhotic patients in this study were hospitalized at a late stage of disease. Further prospective study in a larger sample will be needed to standardize the management protocol in Madagascar.

Topics: Cause of Death; Female; Fever; Gastrointestinal Hemorrhage; Hepatic Encephalopathy; Humans; Liver Cirrhosis; Madagascar; Male; Middle Aged