Volume 86 - 2023 - Fasc.3 - Case series
Biliary papillomatosis
Biliary papillomatosis (BP) is a rare disorder of the biliary tract
characterized by the presence of multiple papillary adenomas spread
along the biliary tree. Although benign, it carries a significant risk
of malignant transformation. Due to low sensitivity and specificity
of conventional radiologic modalities, the diagnosis as well as
estimation of disease extent is difficult. Endoscopic ultrasound
(EUS) and endoscopic retrograde cholangiopancreaticography
(ERCP) are superior although direct peroral cholangioscopy (POC)
is currently the most accurate diagnostic method. Mainly because it
provides more detailed information and makes targeted histological
diagnosis possible. The treatment of biliary papillomatosis consists
of surgical resection, liver transplantation (LT) or a combination
of both. Unfortunately, the recurrence rate after radical surgery
without LT remains high due to the diffuse distribution of the
disease.
Treatment of recurrent Clostridioides difficile infections with faecal microbiota transplantation: peri-procedural methods in a consecutive case series
Background: Faecal microbiota transplantation (FMT) has high efficacy against recurrent Clostridioides difficile infection (CDI). Despite the increasing use of this therapy, the delay between diagnosis and treatment is excessive. Furthermore, donor selection is an important and time-consuming process.
Methods: We reviewed patients who underwent FMT for recurrent CDI at the CHU Charleroi Hospital between 2015 and 2022. The general context, type of administration, adverse events, and donor selection were reported. FMT was conducted using gastroduodenoscopy, colonoscopy, and enema with either fresh or frozen material.
Results: Ten patients with multiple comorbidities were treated by FMT. Seven patients were cured after one procedure. One patient was successfully cured after a change to an unrelated donor, and preliminary efficacy was established.
Conclusions: FMT is an effective treatment that should be considered during the earlier phases of treatment. Stool donors should be thoroughly screened for infectious diseases and other criteria related to microbiota composition.
