South African Gastroenterology Review - latest Issue
Volume 14, Issue 3, 2016
Author Adam MahomedSource: South African Gastroenterology Review 14 (2016)More Less
The changing economic climate locally and internationally will impact on our ability to deliver effective and affordable care to the citizens of South Africa. Challenges will also be felt in the public sector as a result of the 'fees must fall' campaign with already intern posts being unfunded. Dr Stephen Grobler's article about the state of private practice and the constant challenges from the medical aids should make us more vigilant about the rules and regulations in order to offer our patients a fair deal.
Source: South African Gastroenterology Review 14, pp 5 –10 (2016)More Less
A bruit that is heard over the liver most commonly originates from hepatocellular carcinoma (HCC). With the exception of HCC, other conditions may very rarely generate a bruit (Table 1). A bruit for many clinicians may therefore be stigmatic of HCC. The diagnosis of HCC however, according to The American Association for the Study of Liver Disease (AASLD) guidelines, requires imaging. HCC can be confidently diagnosed by the presence of classical CT findings. Alpha fetoprotein (AFP) plays a supporting role because it is normal in fibrolamellar HCC. Percutaneous liver biopsy of mass lesions carries a risk of seeding malignant cells through the tract site. Therefore liver biopsies do not form part of the routine diagnostic workup. A biopsy may however prove necessary when there is diagnostic doubt. In this article we present a case of a young female whose disease masqueraded as HCC by means of hepatomegaly and a bruit, misleading the clinician at the onset.
Source: South African Gastroenterology Review 14, pp 13 –15 (2016)More Less
With the advent of video capsule endoscopy, small bowel ulcerations have become a more common clinical finding. These lesions have a wide differential diagnosis and should be interpreted in the clinical context of the patient presentation, and alongside other appropriate investigations. Here we highlight a case of multiple isolated jejunal ulcerations.
Source: South African Gastroenterology Review 14 (2016)More Less
A 70-year-old man was admitted with massive haematochezia. It was the first episode, and had not been associated with haematemesis, melaena or abdominal pain. He was diabetic and hypertensive, but well controlled on insulin injections and enalapril. He was alert, but pale. The blood pressure was 90/60 mmHg, the pulse was 100/min, and there was fresh blood on rectal examination. The haemoglobin value was 4.7g/dl. Resuscitation was started, and blood transfusion initiated. Gastroscopy revealed a small mucosal defect in the pylorus, with clot on the base, suggestive of Dieulafoy lesion.
Author Stephen GroblerSource: South African Gastroenterology Review 14, pp 19 –20 (2016)More Less
Economic theory dictates that who controls the purse strings, controls everything; this notion is borne out by our current practical experience in healthcare. Medical schemes, their powerful administrators and the dominant hospital groups have "captured" the provision of healthcare in South Africa to such an extent that they are telling doctors how to practice medicine.
Source: South African Gastroenterology Review 14, pp 23 –24 (2016)More Less
This year the Gastroenterology Foundation of South Africa celebrates its 10th anniversary. It is an appropriate time, therefore, to reflect on the achievements the Foundation has made over the past 10 years. It is an exciting time to be in South Africa and indeed in the whole of sub-Saharan Africa. Looming over the horizon and well within our reach lies the birth of the Gastroenterology and Hepatology Association of Sub-Saharan Africa (GHASSA).
Source: South African Gastroenterology Review 14, pp 24 –28 (2016)More Less
Chris Kassianides, Chairman of the Gastroenterology Foundation of South Africa, welcomed everyone and expressed thanks, on behalf of all the Trustees, to Professor Michael Kew, his wife Daphne and his son Garth who accompanied him from Cape Town. He introduced the Foundation by describing its origins as a Liver interest group over 20 years ago that he and Professor Pauline Hall, a hepatic pathologist at the University of Cape Town, had established. He paid tribute to Professor Mike Kew's contributions to Hepatology in South Africa and to the Foundation and, although the Foundation had its origins as a liver group, it has grown and developed over the last 10 years incorporating all aspects of Gastroenterology and Hepatology. Recognition and thanks was given to Jay Hoofnagle, Director of the Liver Disease Research Branch in the Division of Digestive Diseases and Nutrition at the NIH in Bethesda, MD, who hosted three of Mike Kew's fellows in his unit over a period of 20 years - Geoff Dusheiko, Adrian Di Bisceglie and Chris Kassianides.
Paediatric Interest Group Meeting
27 August 2016, Vineyard Hotel, Cape Town : Gastroenterology FoundationAuthor Etienne NelSource: South African Gastroenterology Review 14 (2016)More Less
The Paediatric Interest Group Meeting of the Gastroenterology Foundation of South Africa was held at the Vineyard Hotel in Cape Town on 27 August this year. Topics addressed at the meeting included inflammatory bowel disease in children, transitioning care of adolescent patients, and emerging intestinal diseases (eosinophilic oesophagitis and congenital diarrhoea). Prof Sanja Kolacek was the international speaker while Prof Levin, Sr K Davidson and Dr's Strobele and Nel were the local speakers.
The Gastroenterology Foundation of South Africa & The Gastroenterology Association - Ethiopia
29 September - 1 October 2016, Addis Ababa, Ethiopia : Gastroenterology FoundationAuthor Reid AllySource: South African Gastroenterology Review 14 (2016)More Less
Ethiopia is developing exponentially in terms of infrastructure, airline, airport (although much too small now for the massive amount of transfers), hotels and their service industry. Albeit, the majority of Ethiopians are still poor and probably do not have the same access to healthcare, as we have (despite our problems in the public sector).
Author Eduan DeetlefsSource: South African Gastroenterology Review 14 (2016)More Less
It was my great pleasure to participate in the Gastroenterology Association of South Africa and Gastroenterology Association of Ethiopia's conference in Addis Ababa from 28 September to 1 October 2016. This conference was the first of its kind and comprised a post-graduate training for fellows, best of AGA and best of EASL sessions. A generous sponsorship from Medtronic made it possible for delegates across Africa to meet and discuss their perspectives on gastrointestinal disease in Sub-Saharan Africa. I was asked to present a half day introduction to the use of capsule endoscopy. Medtronic acquired Given Imaging, the originator of PillCam, and the leader in its field.
Author Wendy SpearmanSource: South African Gastroenterology Review 14, pp 33 –37 (2016)More Less
Chris Kassianides, Chairman of the Gastro Foundation of South Africa, in conjunction with EASL put together a whole day symposium of Liver talks at the Gastroenterology Association of Ethiopia meeting in Addis Ababa, Ethiopia. The Faculty included International speakers Professor Massimo Pinzani, Director of the UCL Institute for Liver and Digestive Health; Professor Franco Negro from University of Geneva, Switzerland (Departments of Specialty Medicine, Pathology and Immunology) and Educational Councilor of EASL; and Dr Funmi Lesi from the University of Lagos and Lagos University Teaching Hospital in Nigeria. Local Faculty speakers from Addis Ababa were Drs Abate Bane, Hailemichael Desalegn, Rezene Gebru and Yohannes Berhanu; and the South African speakers were Mark Sonderup and Wendy Spearman from Cape Town.
Northern Cape Lynch Syndrome Surveillance trip 'Splash of Red'
Sunday 27th August - Friday 2nd September 2016 : surveillance tripSource: South African Gastroenterology Review 14, pp 43 –44 (2016)More Less
2016 is the 22nd surveillance trip to the Northern Cape. Above (Picture 1) are 21 of the 32 team members. The additional 11 were part of the PinkDrive squad who followed us on the entire journey this year. Breast surveillance was additionally offered to Colo/Gynae in Upington, Alexander Bay, Garies and Vredendal. The PinkDrive retraced their steps and spent a second week visiting the Verdant mines in Aggenys, Pella and Pofadder. See the latest PinkDrive video on Youtube (google pinkdrive northern cape video) in which our international guest Prof Klaus Matzel, coloproctologist from University Erlangen, Germany, features.