The aim of this study was a prospective search for splenoportal venous obstruction (SPVO) in a medical-surgical series of 266 patients with chronic pancreatitis who were followed up a mean time of 8.2 years. SPVO was systematically searched for using ultrasonography and then confirmed by angiography or computed tomography. SPVO was found in 35 patients (13.2%) but was symptomatic in only two. Initial obstruction involved the splenic vein in 22 patients, the portal vein in 10, and the superior mesenteric vein in three. Since venous obstruction extended from the splenic to the portal vein in five patients, the prevalence of portal obstruction was 5.6% (15/266). Acute pancreatitis and pseudocysts were the probable cause of SPVO in 91.4% of our cases. Half the cases of splenic venous obstruction were related to pseudocysts of the caudal pancreas. Esophageal varices were found in two patients and gastric varices in four at the time of diagnosis and during follow-up. At the end of follow-up, 12 patients had undergone splenopancreatectomy (N = 11) or splenectomy (N = 1). Only one patient was operated on for massive esophageal variceal bleeding, and another patient died due to intractable colic variceal bleeding. In four of six patients operated on with portal vein obstruction, surgery was difficult due to venous collaterals. Ten patients were not operated on and 13 patients operated on were not treated for SPVO. The mean follow-up after diagnosis of SPVO for these final 23 patients was 28.9 months. None of these patients bled.(ABSTRACT TRUNCATED AT 250 WORDS)

In an analysis of data from the CESAME cohort in France, patients with anal and/or perianal Crohn's disease have a high risk of anal cancer, including perianal fistula-related cancer, and a high risk of rectal cancer.

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Objective.-The ultimate goal of the Syseo project is to create a chain of collaborative processes to allow the hepato-gastroenterology endoscopy specialist to manage images easily. Methods.-A field study has been done to better understand and formalize practices and contexts of use. Based on these results, we have designed tools for gastroenterology, tackling several domains of computer science and reusing well-known format or concepts especially DICOM files, semantic retrieval and infocus-breakpoint. Results.-Syseo consists in four main components: (1) a data management system relying on the well-known standard DICOM format; (2) a polyp ontology and description logics to manage gastroenterological images; (3) software to estimate the size of a neoplasia from colonoscopic images and (4) pearly user interfaces to enhance collaboration. Discussion.-Preliminary results of Syseo are quite promising since the proposed solutions enable to efficiently store, annotate, retrieve medical data, while providing relatively accurate measuring tools for physicians and medical staff.

Danazol, a C17 alkylated anabolic steroid, has been tried as a hormonomodulator in the management of systemic lupus erythematosus. We report the case of a patient receiving 400 mg of danazol per day who developed mild pancreatitis associated with hepatitis, both induced by danazol.