Gastro-entero-pancreatic neuroendocrine neoplasms are a rare entity, esophageal localization is even rarer and unfortunately known for its aggressiveness, early dissemination and poor prognosis. We document the case of a 44 years old woman with a metastatic squamous cell carcinoma neuroendocrine features which presented as dysphagia with right side abdominal pain.

Primary malignant tumors of the small intestine are rare tumors. They represent 1 to 5% of all tumors of the digestive tract. The multiplicity of histological types associated with the rarity of these tumors. The small intestine is considered as a clinically silent area and this results in a delay in diagnosis and therefore a non-optimal treatment and a severe prognosis. The objective of our work is to report the epidemiological, diagnostic characteristics of patients with small bowel tumors as well as their endoscopic and histological aspects collected in the hepato-gastroenterology department of the Hassan II University Hospital of Fez. Patient and method:We retrospectively analyzed the clinical records of 8 patients with the diagnosis of small bowel malignancies admitted to our training over a period of 11 years. Results: The average age of our patients was 42 years,The sex ratio M/F was 3, the tumor was revealed by an upper GI hemorrhage in 50%(N: 4) followed by abdominal pain in 37%(N: 3) and koening syndrome in 12%(N: 1). The CT scan showed a parietal thickening in all the cases, of which 1 case showed a mass. Double balloon enteroscopy was performed in 8 patients (100%), the endoscopic aspect revealed an ulcerating process in 75% (N: 6), a tumor of sub-mucosal appearance in 12% (N: 1). An ulcerated jejunal stenosis that could not be crossed in 12% (N:1).the biopsy by enteroscopy had allowed to make the diagnosis in 100% of the cases (N: 8).the histological examination had objectified: lymphomas in 37%( N: 3), GIST in 25% cases (N: 2), adenocarcinomas in 25% cases (N: 2) and neuroendocrine tumor in 12% (N: 1). The evolution was unfavorable in all our cases with a median survival rate of 10 months. Conclusion: Small bowel tumors are rare but interesting because of their great histological diversity. The diagnosis is difficult because of the non-specific symptomatology, In our study the couple imaging -enteroscopy had allowed to establish the diagnosis in all our cases, with predominance of the anatomopathological aspect of lymphoma in 37% of the cases.

Oesophageal peptic stenosis (PS) is a benign and rare complication of chronic gastroesophageal reflux disease (GERD). Upper digestive endoscopy plays a crucial role in the diagnostic and therapeutic management of this pathology. The aim of this study is to describe the epidemiological, endoscopic and evolutionary aspects of PS in our context. Methods: This is a retrospective study realized over a period of 18 years [January 2002-August 2020], including all patients diagnosed as PS. The dilatation was performed by Savary-Gilliard candles or hydrostatic balloons. Results: We included 137 patients.The mean age was 50.2 years [16-88years] with a male predominance (sex ratio M/F of 1.15). one hundred and twenty-nine dilatation procedures were performed. A history of chronic GERD was present in 77% of the patients with a mean duration of 6 years [1-17 years]. The reason behind consultation of our patients was dysphagia in all cases regurgitation in 77% and pyrosis in 25%. The upper endoscopy showed an impassable stenosis in 74.5% and a surmountable stenosis in 25.5% of the cases. The stenosis located in the lower third of esophagus in 75% of the cases, with an average extent of stenosis of 3.5 cm. All our patients were put on proton pump inhibitor (PPI). Dilatation was made bycandles with progressive diameters in 63% and by balloons in 37.2%. The evolution was marked by a clinical improvement in 64.7% of the patients with recurrence in 30% requiring other endoscopic dilatation sessions. No complications were reported. Conclusion: Peptic stenosis is a benign complication of GERD. Endoscopic dilatation associated with PPI is the optimal treatment with good functional results.

Patients with chronic inflammatory bowel disease (IBD) represented by Crohn disease (CD) and ulcerative colitis (UC) are at higher risk for thromboembolic complications (CTE) which are a major cause of morbidity. They are attributed to a pre-thrombotic state induced by the inflammatory activity of this disease. The thrombotic risk inpatients with IBD is underestimated and thromboprophylaxisis not widely implemented in the clinical practice. Many studies on thromboembolism in the IBD populationhave already been carried out, however the precisepathogenesis is still poorly understood. The aim of our study is to determine the prevalence, risk factors and clinical aspects of thrombosis during IBD.

Background: Under the term "foreign bodies" of the upper digestive tract, it is conventional to consider food impactions and foreign bodies ingested accidentally or intentionally [1]. Intentional ingestions are most often sharp or stinging foreign bodies, or even ―body packing” (plastic bags, most often condoms, filled with narcotics) [2]. We’re reporting our successful experience about endoscopic extraction of a "body packing” in a young patient of 27 years old.

Aims The purpose of this work is to identify predictive factors for poor response to endoscopic dilatation during achalasia.

Aims The aim of the work is to evaluate the factors predicting the occurrence of refractory oesophageal strictures.

Aims The objective of our study is to show the correlation between the size of oesophageal varices (OV) and the APRI score

13Apr 2020 PRISE EN CHARGE DES INGESTIONS CAUSTIQUES: EXPERIENCE DU CHU HASSAN II DE FES MANAGEMENT OF CAUSTIC INGESTION: UNIVERSITYHOSPITAL HASSAN II EXPERIENCE M. Bedou , N. Lahmidani , M. Figuigui , M. Lahlali , A. Lamine , H. Abid , M. Elyousfi , D. Benajah , M. El Abkari and A. Ibrahimi Service Dhepato-Gastroenterologie - CHU- Hassan II- Fes.

10Mar 2020 CONGENITAL AFIBRINOGENEMIA COMPLICATED BY A PORTAL CAVERNOMA: ABOUT A CASE M. Bedou , H. Abid , B. Cheikh Ahmed , N. Lahmidani , Alaoui Lamrani .Y , M.El. Yousfi , D. Benajeh , M.El. Abkari and A. Ibrahimi Service Dhepato-Gastroenterologie CHU Hassan II-Fes - Service de radiologie CHU Hassan II Fes. Faculte De Medecine et de Pharmacie de Fes- Universite sidi Mohammed ben Abdellah- Fes.

H. Abid, H. Laarabi, M. Lahlali, A. Lamine, N. Lahmidani, M. Elyousfi, D. Benajah, A. Ibrahimi and M. Elabkari Hepato-Gastroenterology Department, Hassan II University Medical Center, Fez, Morocco, Faculty of Medicine, Sidi Mohammed Ben Abdellah University, Fez Morocco. ...................................................................................................................... Manuscript Info Abstract ......................... ........................................................................ Manuscript History Received: 15 July 2020 Final Accepted: 18 August 2020 Published: September 2020

Introduction The biliothoracic fistula is a fearsome complication of the hydatid cyst ruptured in the thorax because of the lung and hepatic injuries. Its frequency is according around 2.5 to 16%.

La ponction biopsie écho-endoscopique des masses pancréatiques, est une technique permettant par aspiration à l'aiguille fine l'obtention de matériel pour analyse cytohistologique. Elle est indiquée chaque fois qu'un examen histologique peut avoir un intérêt diagnostique et/ou thérapeutique. Nous avons analysé les caractéristiques épidémiologiques, cliniques, radiologiques et écho-endoscopiques des masses pancréatiques dont la décision de l'EE avec cytoponction a été posée en réunion de concertation multidisciplinaire (RCP) ainsi que la rentabilité diagnostique de cette technique.

Le faux kyste du pancréas (FKP) est une complication des pancréatites aiguës ou chroniques dont la régression spontanée est fréquente. Le drainage est réservé aux formes symptomatiques ou compliquées. Le traitement endoscopique est le traitement de référence vu son caractère moins invasif par rapport à la chirurgie, avec moins de recours au drainage radiologique externe et des résultats satisfaisants à long terme. Nous rapportons 26 observations de drainage endoscopique FKP.

L'acromégalie est une maladie liée à une hypersécrétion d'hormone de croissance (growth hormone [GH]), Les recommandations actuelles proposent d'inclure ces patients dans le groupe à risque élevé de cancer colorectal (CCR) et de les surveiller par coloscopie de dépistage.

Certain complementary examinations are essential to make the diagnosis of inflammatory bowel disease (IBD), as well as to establish an initial mapping that seems to be a crucial element in the therapeutic choice. However, the systematic search for lesions in the upper digestive tract is still controversial. The aim of this work is to study the contribution EGD in IBD.

Volvulus of the sigmoid is the most common cause of intestinal obstruction in pregnancy, untreated it evolves towards the intestinal ischemia and the perforation [1]. We report the case of a 38-year-old patient in the third trimester of pregnancy admitted for sigmoid volvulus. Endoscopic devolvulation has been tried with failure. At surgical exploration, the sigmoid volvulus was necrotic. The sigmoid volvulus was resected and Hartman’s colostomy was performed. The purpose of this publication is to show the therapeutic difficulties of this rare association (pregnancy and volvulus). Keys words: volvulus of the sigmoid, pregnancy, endoscopic devolvulation, surgical emergency -------------------------------------------------------------------------------------------------------------------------------------Date of Submission: 20-03-2019 Date of acceptance: 06-04-2019 -------------------------------------------------------------------------------------------------------------------------------------