Open Journal of Gastroenterology and Hepatology


Isolated metastasis of hepatocellular carcinoma in the right atrium: a case observed in a university hospital in West Africa (Bouake, Ivory Coast)

Case Report of Open Journal of Gastroenterology and Hepatology Isolated metastasis of hepatocellular carcinoma in the right atrium: a case observed in a university hospital in West Africa (Bouake, Ivory Coast) Jean Baptiste Okon, Mamadou Diakité, Aké Akoun Fabrice, Koffi Kouadio Olivier Claver, Kone Amadou. University hospital center of Bouake, Ivory Coast. University Alassane Ouattara, Medecine department Intracardiac metastases from hepatocellular carcinoma (HCC) are rare and have a poor prognosis. We report an observation in a West African university hospital in a 39-year-old black patient admitted with upper gastrointestinal bleeding. Clinical examination noted signs of cirrhosis, namely hepatocellular failure, portal hypertension, melena and signs of right heart failure against a background of deterioration in general condition (WHO-3). The CT scan showed a focal hepatic lesion with arterial enhancement and portal lavage compatible with HCC and a right intracardiac mass taking contrast. Doppler echocardiography confirmed the presence of a large heterogeneous mass occupying almost the entire right atrium. Palliative and symptomatic treatment was instituted in the patient improving his clinical condition. His death occurred two months after his release. The intracardiac localization of HCC, although rare, is not exceptional and of appalling prognosis. It should be sought in the assessment of the extension of HCC, especially in the presence of signs of cardiac involvement. Keywords: Intracardiac metastasis, Right atrium, Hepatocellular carcinoma, west Africa ...

Epidemiology and Risk Factors for Hepatitis C Infection in Malaysia: A Narrative Review

Review Article of Open Journal of Gastroenterology and Hepatology Epidemiology and Risk Factors for Hepatitis C Infection in Malaysia: A Narrative Review Mohd Azri Mohd Suan1,2, Salmiah Md Said1*, Ahmad Zaid Fattah Azman1, Muhammad Radzi Abu Hassan2,3 1Department of Community Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia. 2Clinical Research Centre, Hospital Sultanah Bahiyah, KM 6, Jalan Langgar, 05460 Alor Setar, Kedah, Malaysia. 3Department of Medicine, Hospital Sultanah Bahiyah, KM 6, Jalan Langgar, 05460 Alor Setar, Kedah, Malaysia. Hepatitis C infection is a growing public health issue in Malaysia. A large number of people living with hepatitis C virus (HCV) are unaware of the infection. The treatment complexity warrants a comprehensive understanding of this infectious disease to support planning for strategies to reduce the burden of disease associated with hepatitis C. This study aimed to summarise the epidemiology and risk factors attributable to hepatitis C acquisition in Malaysia based on local published articles. Published articles related to epidemiology and risk factors for hepatitis C infection in Malaysia between 2005 and 2017 were searched through several online databases. Related information from the Ministry of Health official website was also compiled. An increasing trend in the incidence and mortality rate of hepatitis C infection is noted over the last decades. In 2009, the national prevalence of people infected with HCV was approximately 2.5%, with the prevalence rate varying according to different high-risk groups. The most common genotypes reported are genotypes 3 and 1. Frequently reported risk factor for HCV acquisition is injection drug use. Other identified risk factors are being a blood product recipient, haemodialysis patient or participant in high-risk sexual activity. Nevertheless, a considerable number of patients had no known risk factors. The prevalence and burden of HCV-related disease are substantial and can be attributed ...

Two-year Single-Center Real-Life Data of Tenofovir Disoproxil Fumarate Treatment for Chronic Hepatitis B Patients in Togo

Research Article of Open Journal of Gastroenterology and Hepatology Two-year Single-Center Real-Life Data of Tenofovir Disoproxil Fumarate Treatment for Chronic Hepatitis B Patients in Togo Aklesso Bagny1,2*, Lidawu Roland-Moïse Kogoe1, Laconi Yeba Kaaga1, Debehoma Redah1,   Late Mawuli Lawson-ananissoh1,2, Henoc Mawunyo Gbolou1, Yendoukoa Yves Kanake1, Koulinga Mikotakatola1 1Departement of Gastroenterology, Teaching hospital campus of Lome, Togo. 2Departement of Gastroenterology, University of Lome, Togo. Objective: to evaluate the treatment efficacy of Tenofovir disoproxil fumarate (TDF) in patients with chronic hepatitis B (CHB) in the Teaching hospital campus of Lome. Patients and method: retrospective cross-sectional study, conducted in the outpatient department of the Hepato-Gastro-Enterology department of the Teaching hospital campus of Lome from January 2018 and December 2020. Patients with HBsAg were included. Outpatient patients having achieved at least HBeAg, anti-HBe antibody, anti-HCV antibody, anti-HBc IgG; viral load hepatic assessment; retroviral serology. Some patients had achieved actitest-fibrotest. Patients with abdominal pain, clinical signs of portal hypertension or hepatocellular insufficiency had achieved alphafetoprotein, protidogram, and abdominal ultrasound. These explorations made it possible to classify patients into different virological profiles. Results: More than sixty-four percent of the patients were male. The patients were asymptomatic at 97.37%. HBeAg was positive in 15.19% of patients. The viral load was detectable in 80.43% of cases with a value of 52000000 IU / ml +/- 280000000UI / ml. Ninety-five point twenty-four patients had an inflammatory activity less than 2 and 52.38% a fibrosis greater than 2 on the Metavir grid. The APRI and Fib-4 scores found a strong predictive value for fibrosis in 16.22% and 11.01% of cases, respectively. HBeAg negative chronic hepatitis was the most common virologic profile (58%). Cirrhosis was the most common complication (9.97%). Tenofovir was the therapeutic molecule used. At 12 months of treatment, HBe seroconversion was noted in 100% of cases, an undetectable viral ...

Carnitine status before and after paracentesis in patients with ascites and liver cirrhosis and improvement of subjective symptoms by intravenous administration of carnitine ― Initial study

Research Article of Open Journal of Gastroenterology and Hepatology Carnitine status before and after paracentesis in patients with ascites and liver cirrhosis and improvement of subjective symptoms by intravenous administration of carnitine ― Initial study Naoki Hotta Department of Internal medicine,Division of Hepatology,Masuko Memorial Hospital; 35-28 Takebashi Nakamura-ku,Nagoya,Aichi,Japan 453-8566 Introduction: Recently, carnitine has been reported to be useful for improving blood ammonia and cognitive function in cirrhotic patients with subclinical hepatic encephalopathy In Japan, levocarnitine has become available, and there have been several reports in which the carnitine concentration was first measured and whether symptomatic patients improved or not . And, the examination of symptomatic state around the ascites centesis was also carried out. Method: Total carnitine concentration was measured in 5 cirrhotic patients undergoing ascites drainage during our hospital ambulatory, and after ascites drainage, intravenous administration of ercarnitine was conducted to examine whether or not the symptoms improved. Carnitine concentrations were measured before and after dialysis in four non-dialysis patients and one dialysis patient. Oral carnitine was administered in 3 patients (1 dialysis patient) because symptoms of cramps were noted, but in 2 cases. It was administered only after ascites drainage. Case presentation: The case was in a 55 year-old male. The chief complaint was persistent ascites, cramps and general malaise. The patient had a medical history of treatment with radiofrequency ablation (Radiofrequency: RFA) for hepatocellular carcinoma. The patient had been followed up at another hospital for chronic liver cirrhosis type C. Interferon therapy was performed for liver cirrhosis, resulting in a virological complete response (sustained virological response: SVR).  The ascites storage was obvious, but the round was repeated from 2 to 3 times a week of golf. Because of frequent leg cramps during and at the end of golf, patients were given branched-chain amino acid preparations and liver ...

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