Télécharger l`article

Editorial
RMC-2010- 3
1
Nous voici arrivés au sixième numéro de la Revue
Médico-Chirurgicale:
Pour la revue « estivale », nous vous proposons un petit
aperçu de l’activité scientifique de nos spécialistes. Nous
avons proposé aux différents services de nous envoyer des
posters présentés dans les congrès scientifiques au cours
de l’année écoulée…
...bonne lecture !
Dr Olivier GILBERT, rédacteur en Chef RMC
RMC-2010- 3 EDITORIAL
p1

Editorial 2010-3
RMC-2010-2 1
SEVERE VAGINAL GVH DISEASE:
A LATE COMPLICATION OF ONCOLOGIC TREATMENT
Riera C., Marechal M., Deroover Y.
Department of obstetrics and gynecologyCHU Civil de Charleroi, Belgium
Les piles, un jeu dangereux!
Pawlik C. ¹, Wauters N.¹, Cavatorta E.¹, Bontems P.², Muyshont L.¹´²
¹Centre Hospitalier Universitaire de Charleroi, Service de Pédiatrie, Charleroi
²Hôpital Universitaire des Enfants Reine Fabiola, Service de Gastroentérologie pédiatrique,
Bruxelles
Neck and mediastinal node dissection in advanced carcinomas
of the upper aerodigestive tract
DIDIER DEQUANTER
Service de Chirurgie Maxillo-faciale,
CHU de Charleroi - Site de Vésale
Purpura thrombocytopénique idiopathique :
Passé, présent et futur…
¹ Pawlik C., ¹ Cavatorta E., ² Ferster A, ¹ Wauters N.
¹ Centre Hospitalier Universitaire de Charleroi, Service de Pédiatrie
² Hôpital des Enfants Reine Fabiola, Service d’hémato-oncologie pédiatrique
Evaluating Benchmarking to Optimize Management of Type
2 Diabetic Patients: The Belgian Data of the Optimise study
M. P. Hermans1, E. Muls2, F. Nobels3, G. Krzentowski4, N. Claes5, N. Debacker6, A.
Matthys7,1 UCL St-LUC, Brussels, Belgium; 2 UZ Gasthuisberg, Leuven, Belgium; 3
OLV Ziekenhuis, Aalst, Belgium; 4 CHU Charleroi, Charleroi, Belgium; 5 Universiteit
Hasselt, Diepenbeek, Begium; 6 Wetenschappelijk Instituut Volksgezondheid, Brussels,
Belgium; 7 AstraZeneca, Brussels, Belgium
RMC numéro 2010-3
Au sommaire
p2

Comité de rédaction
RMC
R
R
R
evue
evue
evue
M
M
M
édico
édico
édico-
-
-
C
C
C
hirurgicale du CHU de Charleroi :
hirurgicale du CHU de Charleroi :
hirurgicale du CHU de Charleroi :
COMITE DE REDACTION
COMITE DE REDACTION
COMITE DE REDACTION
R
M
C
p3

ABSTRACT
RMC-2010 3
1
Riera C., Marechal M., Deroover Y.
Department of obstetrics and gynecologyCHU Civil de Charleroi, Belgium
INTRODUCTION
Female genital GVH (graft versus host) disease occurs after SCT (allogenic stem cell
transplantation) in 25% of the long term survivors. Vaginal GVH disease has been first
described in 1982 (1 ). To date, about 26 severe cases with hematocolpos requiring sur-
gery have been documented and 50% of them experienced recurrence that needed corti-
coid treatment and, in some cases, immunosuppressive therapy. HRT does not protect
against synechia although a large prospective serie demonstrated a good response
should patient be placed under local corticoid application as soon as the GVH vulvar
symtoms appeared. (2).
ABSTRACT
S
SS
S
EVERE VAGINAL GVH DISEASE:
A LATE COMPLICATION OF ONCOLOGIC TREATMENT
p4

ABSTRACT
RMC-2010 3
2
CASE 1
A 22-years-old gravida 0 para 0 virgin patient has consulted for chronic abdominal pain
and amenorrhea. The patient has had a chronic myeloid leukaemia, Ph (+) in 2004, trea-
ted by chemotherapy followed by a SCT. After the treatment, the menopause has been
treated by estro-progestative combination. Four years after the oncologic disease, the pa-
tient has consulted for abdominal pain and amenorrhea. The gynecologic examination
demonstrated a complete obstructed vagina but the palpation failed to point out any ab-
dominal mass. A pelvic ultrasound revealed a hypoéchogenic mass (hematometrocolpos
is suspected). MRI confirmed a large hematometrocolpos.
Fig. 1Surgical lysis of synechia to the cervix and drainage of the hematometrocolpos ha-
ve been performed. Vaginal dilatator used in combination with local estriol and HRT have
been prescribed for 2 weeks. One month after the surgery, the patient experienced nor-
mal menstruation and normal intercourse. After 12 months of follow-up, no recurrence
has been diagnosed.
CASE 2
A 35-years-old patient gravida 0 para 0 consulted for abdominal pain and amenorrhea. A
non-Hodgkin’s lymphoma has been diagnosed in 2000, treated by chemotherapy, whole
body irradiation and SCT. After the treatment; menopause has been treated by HRT and
local estriol. The patient developed a chronic skin GVH disease treated by oral Tacroli-
mus.
Eight years after the SCT, patient developed an abdominal pain. Ultrasound investigation
showed a hematocolpos and clinical examination revealed a painful pelvic mass associa-
ted to an obstructed vagina. Vaginal biopsy highlighted inflammation compound with so-
me lymphocyte T deposits.
No atrophy has been found. The patient had also undergone surgical lysis of synechia. A
vaginal dilatator with local estriol has been prescribed to the patient. One month after the
surgery, recurrence of synechia occurred.
Topical hydrocortisone acetate has been prescribed for two months with good results. Af-
ter 8 months of follow-up, the patient has normal gynecological status.
p5