{"id":2076,"date":"2017-10-01T01:00:00","date_gmt":"2017-10-01T00:00:00","guid":{"rendered":"https:\/\/angh.net\/abstracts\/une-cause-inhabituelle-de-diarrhee\/"},"modified":"2018-10-20T18:40:25","modified_gmt":"2018-10-20T16:40:25","slug":"une-cause-inhabituelle-de-diarrhee","status":"publish","type":"post","link":"https:\/\/angh.net\/abstracts\/une-cause-inhabituelle-de-diarrhee\/","title":{"rendered":"Une cause inhabituelle de diarrh\u00e9e"},"content":{"rendered":"<p><strong>2017<\/strong><\/p>\n<p><em>Cl\u00e9mence Horaist, Mehdi Belhassan, Mathilde Petiet, Vincent Jouannaud, St\u00e9phane Nahon<\/em><\/p>\n<p><strong>Gastroent\u00e9rologie <\/strong>&#8211; \u00a02017-05-06 &#8211;\u00a0CC &#8211;<\/p>\n<p>________________________________<\/p>\n<p>Patiente de 81 ans hospitalis\u00e9e en urgence pour la prise en charge d\u2019une diarrh\u00e9e aigue non glairo sanglante et douleurs abdominales depuis 48h.<br \/>\nDans ses ant\u00e9c\u00e9dents sont retrouv\u00e9s\u00a0: un syndrome d\u00e9pressif trait\u00e9 depuis 10 ans par fluox\u00e9tine \u00e0 la dose de 20 mg par jour, un lymphome folliculaire diagnostiqu\u00e9 en 2006 trait\u00e9 par plusieurs lignes de chimioth\u00e9rapie et depuis janvier 2017 par idelalisib (Zydelig) \u00e0 la dose 150 mg matin et soir.<br \/>\nA l&rsquo;arriv\u00e9e dans le service, la patiente est apyr\u00e9tique, pouls et tension normaux et poids sans modification r\u00e9cente du poids. L\u2019abdomen est sensible dans son ensemble \u00e0 la palpation sans d\u00e9fense. A l\u2019interrogatoire\u00a0: on ne trouve pas de voyage r\u00e9cent, pas de notion de repas \u00e0 risque, pas de contage, pas de nouvelle prise m\u00e9dicamenteuse.<br \/>\nAu bilan biologique\u00a0: Hb 14,2g\/dl\u00a0; lymphocytes 0,4 G\/L\u00a0; TP 88%\u00a0; ASAT 5.5N\u00a0; ALAT 7N\u00a0;GGT et PAL normales,  ionogramme sanguin normal, cr\u00e9atinin\u00e9mie normale, albumine 25 g\/L et CRP normale. Une TDM abdomino pelvienne avec injection de produit de contraste r\u00e9alis\u00e9 montre un \u00e9paississement de la paroi du colon (pr\u00e9dominant au niveau du sigmo\u00efde) sans complication, associ\u00e9 \u00e0 une thrombose de la veine ovarienne droite. Le bilan infectieux (coprocultures, recherche de clostridium difficile toxinog\u00e8ne, examen parasitologique des selles, s\u00e9rologies des h\u00e9patite A, B, C et E, recherche de CMV) est n\u00e9gatif.<br \/>\nLa rectosigmoidoscopie montre des ulc\u00e9rations millim\u00e9triques multiples de la muqueuse rectosigmoidienne avec des intervalles de muqueuse saine. Les biopsies concluent \u00e0 une colite sub-aigu\u00eb chronique avec perte de la mucos\u00e9cr\u00e9tion,\u00a0\u00e9rosions superficielles et apoptose focale.<\/p>\n<p>Quelle est votre hypoth\u00e8se diagnostique\u00a0?<br \/>\nQuelle est votre conduite \u00e0 tenir\u00a0?<\/p>\n","protected":false},"excerpt":{"rendered":"<p>2017 Cl\u00e9mence Horaist, Mehdi Belhassan, Mathilde Petiet, Vincent Jouannaud, St\u00e9phane Nahon Gastroent\u00e9rologie &#8211; \u00a02017-05-06 &#8211;\u00a0CC &#8211; ________________________________ Patiente de 81 ans hospitalis\u00e9e en urgence pour la prise en charge d\u2019une diarrh\u00e9e aigue non glairo sanglante et douleurs abdominales depuis 48h. Dans ses ant\u00e9c\u00e9dents sont retrouv\u00e9s\u00a0: un syndrome d\u00e9pressif trait\u00e9 depuis 10 ans par fluox\u00e9tine \u00e0 [&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":[28],"class_list":["post-2076","post","type-post","status-publish","format-standard","hentry","category-gastroenterologie","tag-28"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Une cause inhabituelle de diarrh\u00e9e - 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\/une-cause-inhabituelle-de-diarrhee\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Une cause inhabituelle de diarrh\u00e9e - 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