[Giant lymphoid hyperplasia of mediastinum (Castleman's syndrome). Two cases (author's transl)]. / [Hyperplasie ganglionnaire géante du médiastin (syndrome de Castleman). A propos de deux observations.

The authors report the cases of two patients with localized lymph node hyperplasia of angio-follicular type. One presents the plasma cell type, biological abnormalities and a shoulder-hand syndrome; the patient recovers after removal surgery. The other, of hyaline vascular type, is asymptomatic.

[Acute post-stress pancreatitis (apropos of 7 cases)]. / Les pancréatites aiguës post-agressives (à propos de sept observations).

The authors report 7 cases of acute non-primary pancreatitis occurring in trauma patients without any initial abdominal injury. Six of the patients were male and the age range 38 to 80 years. Four were hospitalized for trauma with a severe state of shock on admission. In 5 cases there was a thoracic trauma. The complication developed within a period of 3 to 45 days. The clinical picture was scanty, examination of the patient invariably revealing abdominal distension. The diagnosis was based above all on laboratory findings: high blood glucose, independent of carbohydrate instake and insulin therapy. Treatment should first be medical, but if clinical and laboratory abnormalities persist after 12 hours treatment should be surgical: pancreatectomy of adequate extent to deal with the lesions. Pancreatic findings are characterised by their necrotico-haemorrhagic appearance. Lesions of the gland were partial, total or multifocal. The pathogenesis is not defined. Numerous factors have been suggested. The prognosis is grave: five deaths amongst the seven cases.

[Acute post-stress cholecystitis (apropos of 4 cases)]. / Les cholécystites aiguës post-agressives (à proposde quatre observations).

The authors report four cases of acute cholecystitis occurring during intensive therapy. The patients, three male, among the four patients, were aged between 12 and 70 years. They had been hospitalised for surgery with a complicated and septic postoperative course (3 cases), or for acute decompensation of chronic respiratory failure (1 case). The complication developed within a period of 10 to 24 days. The clinical picture was that of an inflammatory obstruction with swelling of the right hypochrondrium. Treatment consisted of cholecystectomy in all four cases. Gall bladder lesions ranged from obstruction to total necrosis. In one case, calculi were found but could not be considered as having been solely responsible. The bile always had a frankly septic appearance. One patient died postoperatively as a result of septicaemia. The pathogenesis remains to be defined. Two components, mechanical and infectious, are most probable.