[Acute post-stress pancreatitis (apropos of 7 cases)]

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.