[Gastric necrosis caused by acute gastric dilatation. Total gastrectomy. Recovery]. / Nécrose gastrique par dilatation gastrique aiguë. Gastrectomie totale. Guérison.

Acute gastric dilatation, a rare affection, has multiple origins. An episode of bulimia following a fast in relation to an anorexia nervosa is one of the classical causes of its onset. Diagnosis is by radiology and should be made urgently before instituting medical treatment combining aspiration and effective intensive care measures. Recovery is the general rule. The formation of an infarct and gastric perforation are complications of delayed diagnosis and are of extreme gravity, leading to a fatal outcome in more than 80% of cases. In the case reported, recovery was obtained by emergency total gastrectomy for global gastric infarction. Perioperative fibroscopy is the essential key to the choice between temporary esophageal exclusion or immediate re-establishment of digestive continuity.

[Short-term obstetrical anesthesia. Study of the tiapride-ketamine combination]. / Anesthésie de courte durée en obstétrique. Etude de l'association tiapride-kétamine.

Minor surgical procedures do not always require hospitalisation for several days. The use of short-acting anaesthetic agents should make such procedures possible on an ambulatory basis. A study was undertaken of the combination of tiapride and ketamine in 97 women seen in the department of obstetrics for therapeutic abortion or biopsy-curettage. The drug combination was satisfactory in the great majority of cases. It is sufficiently analgesic for surgery of this type. The minimal level of narcosis ensures rapid recovery without any subsequent falling asleep again. The psychomotor agitation caused by ketamine is counteracted by the doses of tiapride used. Only vomiting may be felt to be too frequent. Nevertheless, this occurred in women who were fully awake and had no major consequences.