Introduction: l'alternative à l'oesophagectomie pour le traitement de l'EBO avec DHG et/ou cancer superficiel est le traitement endoscopique à condition de pouvoir obtenir l'éradication complète de l'EBO; en cas d'EBO long et circulaire, le protocole thérapeutique idéal reste à préciser. Le but de cette étude est de présenter notre expérience d'une bi et trithérapie séquentielle.

Mucosal pseudolipomatosis of the colon is a rare complication of colonoscopy. It is a benign lesion, and the etiology and pathogenesis of the disorder remain controversial. We report here a case of pseudolipomatosis of the colon discovered during investigation of rectal bleeding.

BACKGROUND:The aim of this study was to prospectively compare the diagnostic accuracy of videoendoscopy, with and without Lugol staining, for the detection of esophageal cancer in alcoholic or smoking patients older than 40 years.METHODS:Daily alcohol and tobacco consumption and overt and latent symptoms were noted. The 158 patients included were examined by videoendoscopy and with Lugol dye.RESULTS:The mean consumption of alcohol and tobacco was 86 +/- 49 gm/day for 26 +/- 11 years, and 30 +/- 18 pack-years, respectively. Twenty-five patients had no symptoms. Before Lugol staining, 12 patients had endoscopically identified cancerous lesions. After Lugol staining, 13 patients had 17 esophageal cancers, 3 of which were high-grade dysplasia. The prevalence of esophageal cancer was 8.2%: 95% CI [4,14]. Dye-free surfaces were significantly larger than the endoscopic patterns observed before Lugol staining (11.6 +/- 9.2 cm2 vs 1.4 +/- 1.7 cm2; p < 0.02).CONCLUSIONS:In an alcoholic smoking population, the prevalence of esophageal cancer detected by endoscopy is high and not related to symptoms described by patients. Lugol staining only moderately improves the diagnostic accuracy of videoendoscopy; its main advantage is the assessment of the mucosal extension of esophageal cancer.

Of 62 patients with rectal carcinoma, who were examined by endorectal ultrasound (EER) before operation, 15 were examined after preoperative external radiation therapy. The results were compared to histological and surgical findings according to the TNM classification. When preoperative radiation therapy was not applied, the diagnostic value of EER was excellent, as well as for the detection of perirectal fat spread as for lymph node involvement. The diagnostic accuracy was respectively 87.2% (CI: 74-95) and 78.0% (CI: 62-90). After irradiation, the diagnostic value was much lower. The diagnostic accuracy was 60% (CI:33-84) and 40% (CI:18-68) for perirectal fat spread and nodal involvement, respectively. This loss of information was due to a decrease in specificity. Radiation treatment was responsible for the occurrence of hypoechoic nodal images and peritumoral hypoechoic areas resulting in an overestimation of the extent of involvement. After irradiation of a rectal malignant tumor, the classical EER signs are no longer adequate to predict locoregional involvement. Endosonographic semiology must be modified to describe the tumor response to non surgical treatment.

Of 62 patients with rectal carcinoma, who were examined by endorectal ultrasound (EER) before operation, 15 were examined after preoperative external radiation therapy. The results were compared to histological and surgical findings according to the TNM classification. When preoperative radiation therapy was not applied, the diagnostic value of EER was excellent, as well as for the detection of perirectal fat spread as for lymph node involvement. The diagnostic accuracy was respectively 87.2 % (CI: 74-95) and 78.0 % (CI: 62-90). After irradiation, the diagnostic value was much lower. The diagnostic accuracy was 60 % (CI: 33-84) and 40 % (CI : 18-68) for perirectal fat spread and nodal involvement, respectively. This loss of information was due to a decrease in specificity. Radiation treatment was responsible for the occurrence of hypoechoic nodal images and peritumoral hypoechoic areas resulting in an overestimation of the extent of involvement. After irradiation of a rectal malignant tumor, the classical EER signs are no longer adequate to predict locoregional involvement. Endosonographic semiology must be modified to describe the tumor response to non surgical treatment.