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- W2912397440 abstract "Les colites parasitaires, très largement dominées par l'amibiase, les bilharzioses et la trichocéphalose, déterminent des entités aux multiples facettes, d'expression aiguë ou chronique ou souvent asymptomatique. Le côlon peut ainsi être concerné par des parasites cosmopolites ou exotiques, d'incidence et de prévalence éminemment variables, en simple transit, hôtes habituels ou piégés dans la paroi colique. Les conséquences vont de l'épiphénomène aux manifestations anatomocliniques potentiellement graves mettant en jeu le pronostic vital. La physiopathologie résulte d'interactions avec l'hôte, le milieu extérieur et le parasite dont l'agression met en jeu des contraintes mécaniques pariétales et des phénomènes inflammatoires immunomédiés ou liés aux enzymes parasitaires. Trois regroupements circonstanciels individualisent les colites parasitaires tropicales communes, les colites parasitaires favorisées par l'immunodépression et le cas particulier des impasses parasitaires à tropisme colique. La démarche diagnostique, centrée sur l'anamnèse, cherche à obtenir l'identification du parasite en cause par sa détection dans les selles quand elle est possible, et par l'endoscopie rectocolique qui étaye le diagnostic anatomoclinique. Le traitement fait appel à trois classes historiques de médicaments antiparasitaires (5-nitroimidazolés, benzimidazolés, praziquantel), et à des molécules plus récentes ou redécouvertes (ivermectine, nitazoxanide), plus rarement à la chirurgie dans les formes compliquées ou de diagnostic incertain. Parasitic colonic diseases refer to a polymorphic concept; they may present an acute or a chronic expression, often non symptomatic, and they include the amoebosis and the schistosomiasis which are dominant in tropical countries. The colon may be concerned by cosmopolitan or exotic parasites with highly variable incidence and prevalence, simply in transit, or as usual hosts, or trapped in the colonic wall. The consequences range from the epiphenomenona to anatomo-clinical manifestations potentially serious and life threatening. The pathophysiology results from interactions between the host, the external environment and the parasite; the parasite aggression involves immunomediated inflammatory or parasitic enzyme related phenomena. Three groups of parasitic colitis have been identified, with a distinct identity: the common parasitic tropical colitis, the parasitic colitis favoured by immunodepression, and the specific parasitic colonic deadlock with colic tropism. The diagnosis focuses on the anamnesis and seeks for the involved parasite identification by stool analysis when possible, and by the colorectal endoscopy which supports the anatomo-clinical diagnosis. As for the treatment, three antiparasitic classes (5-nitro-imidazole agents, benzimidazole agents, and praziquantel), and more recent molecules (ivermectine, nitazoxanide) are available; less frequently, surgery is indicated, for the complicated forms or in case of unascertained diagnosis." @default.
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- W2912397440 date "2005-04-01" @default.
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- W2912397440 title "Colites parasitaires" @default.
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- W2912397440 doi "https://doi.org/10.1016/j.emchg.2005.01.004" @default.
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