Showing papers by "K.H. Katsanos published in 2004"

Choledochoduodenal fistula: an unusual complication of penetrated duodenal ulcer disease

Abstract: Spontaneous choledochoduodenal fistula in the absence of primary biliary disease is a very unusual complication of duodenal ulcer disease. In most cases it is diagnosed incidentally, because it seldom gives clinical manifestations. Although surgical approaches have been the treatment of choice in the past, the use of modern antisecretory drugs turns now management strategy to more controversial issues, as the fistula per se is not an indication for surgery.

Thigh abscess following acute diverticulitis. Report of two cases

Abstract: SUMMARY The incidence of inflammatory diverticular disease in patients with diverticulosis has been reported to range from 12%-35%. Delayed diagnosis and treatment of perforated diverticulitis is accompanied by high mortality. Perforation of diverticulum is often localized and may result in abscess formation. This abscess may resolve, may rupture into the peritoneal cavity or may drain into various organs or viscera. Finally, the abscess may track intraperitoneally or extraperitoneally. In both cases presented here, there was a communication of the inflammatory divericular disease of the sigmoid colon with an abscess cavity in the Scarpais triangle, tracking down through the femoral canal in the first case, and through the abdominal wall in the second case. The underlying intraabdominal lesion was treated by sigmoidectomy according to Hartmannis procedure in the first case and by sigmoidectomy and an end- to- end anastomosis in the second. These procedures were combined with local drainage of the thigh abscesses with good results. In conclusion, it becomes apparent that in such cases, where the underlying intraabdominal lesion is overlooked, the mortality rate is as high as 93%. However, if the underlying intraperitoneal pathology is early recognised and successfully treated, in combination with thigh abscess management, the overall mortality drops to 34%.

Screening program on hepatitis B in young Albanian population: The Greek-Albanian collaborative study on the prevention of hepatitis B (the HEPAGA project)

Abstract: SUMMARY Aim: The aim of the study was to screen for hepatitis B virus (HBV) in a well-defined, young, population in the area of Tirana, Albania (the HEPAGA project). Patients-Method: This study was conducted under the auspices and with grants from the Greek Ministry of Development and the Albanian Ministry of Education and science. This collaborative study lasted for two years (20012002) and was successfully completed on both sides. Serum samples from the non-vaccinated, young population (ages 14-20) living in a well-defined area of Tirana were collected during the period from September 2001 to February 2002 and were stored at -20 o C until assayed at the Blood Bank of the Ioannina University Hospital. Every sample was examined for HBV immunology profile using routine methods. In case of gray zone results double testing was performed. In cases of insufficient serum we tested, in priority, HBsAg, then HBcore antibody (anti-) and then antiHBs. Results were then sent back to Albania where Albanian

Infliximab for hidradenitis suppurativa in Crohn's disease

Abstract: taining long-term remission in fistulizing Crohn’s disease still remains under debate. The dosage of concurrent medications was reported to be stable or even decreased during Infliximab therapy in these case series of Sullivan et al. We feel that drug dosage reduction or even drug discontinuation in severe cases of HS must be decided after achieving the optimal long-term result with Infliximab infusions. The accumulating experience with Infliximab use in fistulizing Crohn’s disease patients with or without extraintestinal manifestations, including HS, underlines the importance of concurrent treatment acting as a pyramid in which Infliximab represents the top. In addition, physicians should be insisting on this therapy, as, in our experience it seems that enterocutaneous fistula closure precedes the healing of HS lesions. Tapering of concurrent medications, when decided, must be done under a close patient follow-up and after several Infliximab doses, in order to prevent disease relapse or even complete failure of treatment and patient disappointment. In fact, in our patient with Crohn’s disease and HS, we achieved significant reduction of medical treatment during these four years; corticosteroid tapering (methylprednizolone from 16mg/day to 4mg every second day) and HS local therapy discontinuation while azathioprine was maintained at the pre-Infliximab dosage levels (150mg/day).