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- Volume 12, Issue 3, 2014
South African Gastroenterology Review - Volume 12, Issue 3, 2014
Volume 12, Issue 3, 2014
Author A.D. MahomedSource: South African Gastroenterology Review 12 (2014)More Less
2014 was a year with numerous successful educational activities that were undertaken by SAGES as well as the Gastro Foundation. This year has also been exceptional with our academic centres producing numerous gastroenterologists, surgical gastroenterologists and paediatric gastroenterologists. The future of academic gastroenterology looks promising with most training units having excellent fellows with a number of units now training many candidates from Africa. This year has seen the first group of gastroenterology trainees from African countries completing the Gastroenterology certificate.
Author Christo Van RensburgSource: South African Gastroenterology Review 12 (2014)More Less
Source: South African Gastroenterology Review 12, pp 7 –11 (2014)More Less
Autoimmune hepatitis has been recognised since 1940s and was then known as chronic active hepatitis (CAH), described as a novel form of hepatitis found in females noted to have hypergammaglobulinaemia. In the 1960s it was noted to respond to corticosteroids, and in 1993, AIH was endorsed as a clinical entity.
AIH is an unresolving chronic inflammatory condition of the liver resulting from an unknown cause. For this to happen there is a complex interaction of trigger factors, autoantigens, genetic predispositions, and immune-regulatory systems.
AIH is characterized by interface hepatitis and piecemeal necrosis, with a plasmalymphocytic infiltration on histological examination. In addition to this there is increased immunoglobulin G (IgG), elevated alanine aminotransferase (ALT) levels, and liver specific and non-liver specific autoantibodies autoantibodies in the serum.
A quick diagnosis and immunosuppressive therapy in patients with AIH can contain the disease activity and result in a normal life expectancy. Early diagnosis however can prove very difficult because of the heterogeneous nature of the clinical picture and the fact that there is no specific tests applicable to all patients.
Delaying therapy in the management of Hepatitis C Virus infected patients : patient warehousing : reviewSource: South African Gastroenterology Review 12, pp 13 –15 (2014)More Less
Evolution of the management of Hepatitis C Virus in the last decade has progressed at a rapid rate. Further advances in this field and the slow progression of disease have created an opportunity for warehousing patients. This article presents a case history that warrants a decision to be made regarding immediate treatment or warehousing. This is followed by a review of the literature that guides such decision making.
Source: South African Gastroenterology Review 12, pp 17 –18 (2014)More Less
Anabolic or Androgenic Steroids are increasingly being used by men for increased athletic performance and cosmetic gain. Many individuals acquire these substances without the guidance of a medical professional and without knowledge of the potential side effects. We present a 22 year old male, Mr JW a rugby player with a cholestatic liver injury secondary to 2a, 17a-dimethyl-5a-androst-3-one-17b-ol or Methastabol.
Source: South African Gastroenterology Review 12 (2014)More Less
Distinguishing hepatocellular carcinoma from cholangiocarcinoma in a patient with haemobilia and cholangitis : case reportSource: South African Gastroenterology Review 12, pp 21 –24 (2014)More Less
Historically, the distinction between hepatocellular carcinoma (HCC) and cholangiocarcinoma has been difficult for clinicians. Durand-Fardel first described a liver cancer that originated from the bile duct and not the parenchyma in 1840. The turning point had occurred in 1911 when histology differentiated HCC from cholangiocarcinoma. The American Association for the Study of Liver Disease (AASLD) guidelines recommends that the diagnosis of HCC can be confidently made in patients at risk by classical CT findings with alpha fetoprotein (AFP) playing a minor supporting role. Liver biopsy is thus not routinely performed for diagnosis. Furthermore, apart from the usual risks clinicians are reluctant to perform percutaneous liver biopsy of liver mass lesions due to concerns regarding needle tract seeding of malignant cells. Herein we present a case of a young retroviral positive patient with multiple liver mass lesions complicated by cholangitis and haemobilia. The value and limitations of AFP and the classic hepatic bruit in diagnosing HCC are briefly reviewed. In addition we look at the evidence supporting occult hepatitis B virus (HBV) as a risk for HCC.
Author David EpsteinSource: South African Gastroenterology Review 12 (2014)More Less
SAGES hosted another successful Patient IBD Meeting at ISUCRS / SAGES Congress at the Cape Town ICC in September 2014. This meeting, first held in 2011, has become a regular feature on the SAGES programme. The popularity of this IBD patient forum has increased over the years and 117 Patients and 84 concerned family members attended the meeting.
Author Dion LevinSource: South African Gastroenterology Review 12 (2014)More Less
On 4 September 2014, as part of the SAGES/ISURS Congress, a general practice update was held at the Cape Town Convention Centre. Complementary educational GP programmes, which are CPD accredited, have been part of SAGES congresses over the past number of years. These have been well attended in the past and 85 family physicians attended this update. The content of the update has traditionally been only that of general gastrointestinal topics considered of interest to the family physician.
Source: South African Gastroenterology Review 12, pp 30 –31 (2014)More Less
The Inaugural Solly Marks Memorial Lecture was yet another landmark in the 55 years since the inception of the clinic he founded. Sadly Prof IN Marks the founder of the UCT GI Clinic at Groote Schuur Hospital and the South African Gastroenterology Society died on 19 October 2012. His contribution to the development of gastroenterology both locally and internationally is profound in both academic and scientific terms and an accolade to his alma mater the University of Cape Town.