Search

Seven cases of pancreatic pleuropneumopathy are presented and the relevant literature is examined. Treatment of this unusual complications is an offshoot of the modern management of the underlying disease. Attention is drawn to the possibility of serious and sudden acute chest pictures with a clinical picture reminiscent of pancreatic storm. Resuscitation, pneumological and surgical management is required. The histological data for the series shows that a pleural response to the action of matter excreted by the pancreas was responsible. Early local treatment and physiotherapy may be followed by a surprising degree of functional recovery.

The occasions on which lung embolism is likely to occur and proceed with or without initial clinical symptoms are described. Lung scintiscanning technique, complemented by special expedients and personal experience, is explained. It is felt that the method helps in the early detection of suspect or clinically silent forms, as well as in the corroboration or ruling out of a clinical diagnosis as soon as this is possible. Scintiscanning is also of assistance in showing the anatomopathological features and extent of the process. The technique is simple and readily tolerated, even by patients with slight respiratory or circulatory disturbances. On the other hand, it is not competitive with conventional and well-tried angiopneumography.

Radioopaque hemithorax is frequently observed. The various situations in which it may occur are examined aetiopathologically, along with the general and specifically radiological methods used for its investigation. Particular attention is given to the employment of radio-isotopes for this purpose and the methods involved. Results obtained with perfusion are noteworthy, and even more so those achieved with positive tracers such as 67Ga citrate and 57Co Blm, especially in the differential diagnosis of pleural effusion and mesothelioma through what is described as the "paradox effect".

Following a number of remarks on the desirability of introducing into the practice of bronchopulmonary cancer surgery certain immunological ideas, a monitoring programme to be adopted in candidates for lung exeresis and for their subsequent monitoring is presented. The data to emerge thus far may be correlated fairly precisely with the prognosis and from this point of view their use in the selection of patients to be operated might be hypothesised.

The results obtained with levamisole in the immunostimulating of 59 resected and non-resected lung carcinoma patients are presented. The effectiveness of the treatment was assessed in terms of survival, length of the free interval, etc. Cutireaction to the drug was repeatedly monitored. It is felt that the overall results were insufficient evidence of the true effectiveness of this manner of treatment, even though some data indicative of the therapeutic action of the drug were obtained.

A brief reference is made to the part once assigned to scintiscanning as a method of approach to diseases of the pancreas. It is felt that the lack of confidence now displayed in this technique is based preconceptions. A new diagnostic approach is therefore proposed and briefly described. The advantages and disadvantages of the diagnostic techniques included in the proposed scheme are examined. The view is expressed that a fresh assessment should be made of nuclear pancreatography, since it is still a fundamental diagnostic tool.