[Acute hyperlipemic pancreatitis (2 cases)]. / Les pancréatites aiguës hyperlipidémiques (2 cas).

UNLABELLED: THE AIM of this work was to study the clinical and therapeutic features of this affection. CASE REPORT: Our retrospective study concerned two cases of hyperlipemic pancreatitis treated during 6 years from 1998 to 2003. The incidence of this affection was 1.42%. Our patients were respectively a man aged 32 years without any significant history and a pregnant woman aged 24 years with a positive history of dyslipidemia. Clinical, biologic and radiological data didn't differ from those of other causes of acute pancreatitis. The hyperlipemic origin was confirmed by a lactescent serum and a rate of triglycerides greater than 10 g/l. The course was characterized by the recurrence of pancreatitis related to the increased triglycerid serum level over 10 g/l. Plasmapheresis and administration of heparin and/or insulin seem to be efficient in reducing the serum level of triglyceride and in improving the course. Hygieno-dietary measures and hypolipemiant treatment were necessary for the level of triglyceirdes in serum below 10 g/l. We in the absence of comolicatons, surgery seemed umnecessry in the two cases. CONCLUSION: the clinical pattern of acute hyperlipemic pancreatitis doesn't include any specific elements, but its treatment and prevention must take into account the associated hyperlipidemia.

[Cystic lymphangioma of the abdominal cavity. Report of 11 cases]. / Les lymphangiomes kystiques des espaces abdominaux. A propos de 11 cas.

OBJECTIVE: Our aim was to assess the epidemiological particularities, the circumstances of the diagnosis and the therapeutic indications of the cystic lymphangioma of the abdominal spaces. METHODS: Our retrospective and analytic survey concerns 11 cases of cystic lymphangioma of the abdominal spaces: mesentere 6 cases, epiploon 1 case, retroperitoneum 3 cases and under peritoneum 1 case. The incidence was of 1/2476 hospitalizations (0.04%). RESULTS: The median age was 28 years. The sex-ratio was of 1.2. The main circumstance of discovery of the cystic lymphangioma was an abdominal mass in 7 cases. The other circumstances were: a pseudoappendicular syndrome, an ascitis, a disembowelment and a direct traumatism of the abdomen. Total resection of the cystic lymphangioma was performed in 7 cases. In 4 cases a simple enucleation and in 3 cases a resection of a segment of the organ that supports the lymphangioma. Only a partial resection of the lymphangioma has been achieved for the remnant patient. A cystic lymphangioma relapsed 13 years after a total resection in one case. Mortality rate was nul. CONCLUSION: The circumstances of diagnosis of the cystic lymphangioma were in relation with the volume of the tumor or a mechanical, infectious or hemorrhagic complications. The recidivism after a total resection let evoke the possibility of multiple and diffuse cystic lymphangioma.

[Tumors of the vaterian region indications, findings and prognosis : about 49 cases]. / Les tumeurs de la region vaterienne: indications, resultats et pronostic: a propos de 49 cas.

This retrospective study is about 49 cases of tumors of the vaterian region collected between 1976 and 2001. Tumors of the vaterian region represented 7% of the bilio-pancreatic tumors. The study was about 18 women and 31 men, with sex-ratio of 1.7. The mean age was 61 years. Treatment was surgical : cephalic duodeno-pancreatectomy (28 patients) or ampullectomy (5 patients). Rate of tumor resectability was 69.4%. Bilio-digestive derivation was practiced on 13 patients and therapeutic abstention was decided for 3 patients. Age over 65 years, rate of bilirubine superior to 120 mmol/l and surgery done in emergency were elements of bad prognosis that increased post-operative mortality of following cephalic duodeno-pancreatectomy. Global mortality and morbidity were respectively 16% and 24%. Factors of poor prognosis were essentially: Tumor of large size, infiltration of the surrounding structures and tumor with metastases. The survival after bilio-digestive derivation didn't pass the 8 months. Five year survivals cephalic duodeno-pancréatectomy represented 20%. It depended on the degree of the local invasion. This 5 years survival rate to was 85% for stage I (classification of Martin) and 10% for stage IV.