Introduction: A proper bowel cleansing improves detection of colorectal polyps and cancers. Osmotically balanced polyethylene glycol (PEG 4000) based electrolytes solution such as FORTRANS® has been proven effective and secure in achieving rapid colonic cleansing. Oral sodium phosphate (NaP), such as FLEET® Phospo-Soda, is a recent available alternative to PEG. Aims & Methods: The primary aim was to compare PEG versus NaP in term of quality of the preparation defined by a clean intestinal mucosa without any suspected induced lesions (erosion, aphtous like ulcer, petechia, oedema). Clinical and biological safety and acceptability were also compared. Eighty nine patients = 43 in PEG group, 46 in NaP group, median age: 61 years (28 to 81), requiring a total colonoscopy, were recruited in a multicentre, single blind, randomized, parallel groups study. One biopsy was systematically taken in the sigmoid and in case of suspected induced macroscopically lesions. Biopsies were analyzed by the same histopathologist. Blood and urinary assessments were performed at baseline and just after bowel cleansing preparation, including electrolytes (Na+, K+, Cl-, CO3H2-), and urea, creatinine, phosphorus, calcium, hematocrit, osmolality, total protein in the serum. Results: Quality of the preparation: success rate = 51.2% in PEG group vs 47.8% in NaP group (NS). Median score for aphtous like ulcer and/or erosion of mucosa for overall regions was higher in NaP group (0 to 8) than in PEG group (0 to 3) (p<0.03). Acceptability by the patient: good = 62.5% in PEG vs 69.8% of patients in NaP group (NS). Hyperphosphatemia was found in none patient in PEG group and 73.7% of patients in NaP group (p<0.0001). Calcemia quantitatively decreased more in NaP than in PEG group (p<0.03). Hypokalemia: 61.0% of patients in Nap group, 23.7% in PEG group (p<0.002) with a marked decrease of kalemia (< 3 mmol/l = grade 3 of WHO common toxicity criteria) in 10.9% of patients of NaP and 2.3% in PEG group. Conclusion: Quality of the preparation was better in PEG than in NaP group but difference was not significant. Lesions suspected induced by the colonic cleansing were significantly more frequent in NaP group. Moreover biological tolerance was good in PEG group but questionable in NaP group where frequent and marked hypokalemia and hyperphosphatemia were evidenced.

Diffuse cavernous hoemangioma of the rectum is rare. Correct identification is often delayed. The patients usually present with rectal bleeding. We describe two men who had diffuse cavernous hoemangiomas. They complained of rectal pain. One appeared to have a rectal tumor and the other a levator syndrome.

Increased anal canal pressure is often the cause of severe anal pain and results in difficulty in performing anal examinations in patients with anal fissure. Sublingual administration of glyceryl trinitrate (Natispray(R)) has been shown to reduce hypertonia of the internal sphincter [1].

A case of esophageal Papilloma is reported. The viral condyloma was diagnosed by standard histological methods and confirmed by immuno-fluorescence and immuno-peroxidase technics against genus specific Papilloma virus antigens (i. e. capsid specific proteic antigen). These antigens were localized in the nuclei of koilocytic cells. These results confirm the association between proliferative lesions appearing on the mucosal epithelium and Papilloma viruses, which are suspected to be oncogenic in other malpighian tissues.

The authors report a case of diffuse gastric polyposis predominating in the antrum. They emphasize the interest of double contrast radiological examination of the mucosa and fiberendoscopy with biopsy, in the diagnosis.