{"id":1773,"date":"2004-10-01T01:00:00","date_gmt":"2004-10-01T00:00:00","guid":{"rendered":"https:\/\/angh.net\/abstracts\/eclomes-sporadiques-de-type-iii-reveles-par-une-hemorragie-digestive-haute\/"},"modified":"2018-10-20T18:39:34","modified_gmt":"2018-10-20T16:39:34","slug":"eclomes-sporadiques-de-type-iii-reveles-par-une-hemorragie-digestive-haute","status":"publish","type":"post","link":"https:\/\/angh.net\/abstracts\/eclomes-sporadiques-de-type-iii-reveles-par-une-hemorragie-digestive-haute\/","title":{"rendered":"ECLOMES SPORADIQUES DE TYPE III REVELES PAR UNE HEMORRAGIE DIGESTIVE HAUTE"},"content":{"rendered":"<p><strong>2004<\/strong><\/p>\n<p><em>G. BELLA\u00cfCHE (1), D. BRASSIER (2), L. CHOUDAT (3), JEANNE BELLOC (1),<br \/>\nG. TORDJMAN (1), GENEVIEVE LEY (1), JEAN-LUC SLAMA (1).<br \/>\nService de Gastroent\u00e9rologie (1), de Chirurgie visc\u00e9rale (2) et d\u2019Anatomopathologie (3), H\u00f4pital Robert Ballanger, 93600 Aulnay-sous-Bois.<\/em><\/p>\n<p><strong>Gastroent\u00e9rologie <\/strong>&#8211; \u00a02004-09-14 &#8211;\u00a0CO &#8211;<\/p>\n<p>________________________________<\/p>\n<p>Une patiente de 37 ans, sans aucun ant\u00e9c\u00e9dent notable, \u00e9tait hospitalis\u00e9e pour m\u00e9l\u00e9na et an\u00e9mie \u00e0 6,8 g\/dL. Elle ne prenait pas de m\u00e9dicament gastrotoxique. La fibroscopie gastrique permettait de rapporter le saignement \u00e0 des l\u00e9sions polypo\u00efdes ulc\u00e9r\u00e9es de fundus gastrique. Les biopsies trop superficielles ne permettaient aucune conclusion claire. La patiente b\u00e9n\u00e9ficiait, sous anesth\u00e9sie g\u00e9n\u00e9rale d\u2019une coloscopie totale normale et d\u2019une nouvelle gastroscopie avec macrobiopsie \u00e0 l\u2019anse diathermique d\u2019une des multiples l\u00e9sions de 5 \u00e0 30 mm, exulc\u00e9r\u00e9es \u00e0 leur sommet (photo 1). Le diagnostic anatomopathologique de la pi\u00e8ce rapport\u00e9e \u00e9tait celui d\u2019ECLomes gastriques multiples, tumeurs endocrines de l\u2019estomac d\u00e9velopp\u00e9es au d\u00e9pens des cellules ECL (\u00ab ent\u00e9rochromaffines Like Cells \u00bb) (photo 2). Il n\u2019existait aucun argument pour le diagnostic d\u2019ECLomes de type I (&gt;80 % des cas) secondaire \u00e0 une gastrite atrophique type Biermer : les biopsies \u00e0 distance des l\u00e9sions ne montraient pas d\u2019atrophie fundique, la gastrin\u00e9mie \u00e9tait inf\u00e9rieure \u00e0 2N, la vitamine B12 s\u00e9rique normale et on notait l\u2019absence d\u2019anticorps anti-estomac et anti-facteur intrins\u00e8que. De plus, il ne s\u2019agissait pas d\u2019ECLomes de type II (10 \u00e0 15 % des cas), observ\u00e9s au cours du Syndrome de Zolinger-Ellison : il n\u2019y avait pas d\u2019hypersecr\u00e9tion gastrique, le scanner et l\u2019\u00e9cho-endoscopie pancr\u00e9atique ne montraient pas de tumeur duod\u00e9nale ni pancr\u00e9atique mais montrait des l\u00e9sions multiples en grappe du fundus (photo 3), la gastrin\u00e9mie \u00e9tait normale et il  n\u2019y avait pas d\u2019argument en faveur d\u2019une NEM de type I (calc\u00e9mie et PTH normale, bilan hormonal complet normal, IRM hypophysaire normale). Il s\u2019agit donc d\u2019ECLOmes sporadiques de  type III de haut grade malignit\u00e9. La patiente a eu une gastrectomie totale confirmant le diagnostic d\u2019ECLomes malins T3N+M0 (photos 4 et 5).<br \/>\nIl s\u2019agit d\u2019une observation exceptionnelle (2 autres cas dans la litt\u00e9rature) d\u2019ECLomes fundiques gastriques de type III T3N+M0, r\u00e9v\u00e9l\u00e9es par une h\u00e9morragie digestive haute.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>2004 G. BELLA\u00cfCHE (1), D. BRASSIER (2), L. CHOUDAT (3), JEANNE BELLOC (1), G. TORDJMAN (1), GENEVIEVE LEY (1), JEAN-LUC SLAMA (1). Service de Gastroent\u00e9rologie (1), de Chirurgie visc\u00e9rale (2) et d\u2019Anatomopathologie (3), H\u00f4pital Robert Ballanger, 93600 Aulnay-sous-Bois. Gastroent\u00e9rologie &#8211; \u00a02004-09-14 &#8211;\u00a0CO &#8211; ________________________________ Une patiente de 37 ans, sans aucun ant\u00e9c\u00e9dent notable, \u00e9tait hospitalis\u00e9e [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[4],"tags":[15],"class_list":["post-1773","post","type-post","status-publish","format-standard","hentry","category-gastroenterologie","tag-15"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ECLOMES SPORADIQUES DE TYPE III REVELES PAR UNE HEMORRAGIE DIGESTIVE HAUTE - Abstracts des congr\u00e8s de l&#039;ANGH<\/title>\n<meta name=\"description\" content=\"ANGH R\u00e9sum\u00e9s congr\u00e8s H\u00e9patologie Gastroent\u00e9romogie Hepatology Gastroenterology Etudes cliniques Clinical study\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/angh.net\/abstracts\/eclomes-sporadiques-de-type-iii-reveles-par-une-hemorragie-digestive-haute\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ECLOMES SPORADIQUES DE TYPE III REVELES PAR UNE HEMORRAGIE DIGESTIVE HAUTE - 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