Gastrosplenic fistula following successful chemotherapy for disseminated histiocytic lymphoma.

A case is presented of a patient with diffuse histiocytic lymphoma with splenic involvement who developed a communication between the greater gastric curvature and the splenic parenchyma after successful antineoplastic chemotherapy. This fistula was diagnosed by CT scan and confirmed by upper gastrointestinal barium series and fiberoptic endoscopy. This complication was managed successfully by an enbloc resection of the greater curvature of the stomach, splenectomy, and distal pancreatectomy.

Lymphocyte function in anergic patients.

The lymphocyte function of anergic surgical patients who are at increased risk for sepsis and mortality was studied. In vitro lymphocyte responses appear to be normal in most instances, in that over 80% of patients showed a normal response in a standardized mixed leucocyte culture reaction. Similarly, 56% of the lymphocytes from anergic patients showed a positive in vitro proliferative response with PPD.

Delayed perforation of the colon in blunt abdominal trauma.

The authors describe three patients with similar clinical features and patterns of colonic injury following blunt abdominal trauma. Perforation was discovered 7 to 10 days after injury and was indicated by the clinical signs of systemic sepsis. A prominent sign of occult sepsis was post-traumatic pulmonary insufficiency.

Delayed hypersensitivity and neutrophil chemotaxis: effect of trauma.

To investigate alterations in host defense produced by trauma, skin testing with five standard recall antigens was done on admission and weekly on 53 patients with blunt trauma and seven with penetrating missile injuries, who then were classified as normal (N), 2 or more positive responses; relatively anergic (RA), one positive response; or anergic (A), no response. Neutrophil chemotaxis was tested 145 times in 32 patients. Degree of injury was assessed by assigning one point to pelvic fracture, long-bone fracture, head, chest, or abdominal injury, to a maximum of five.