Vingt patients ayant un tableau clinique et biologique evocateur d'hyperaldosteronisme primaire (HAP) ont ete operes apres un bilan ayant comporte une tomodensitometrie associee dans 13 cas a une phlebographie surrenalienne couplee a des dosages veineux etages. Le taux de resultats positifs de ces trois examens paracliniques sont respectivement de 73, 78, 89%. Tous les patients sauf un, ont ete operes par une voie d'abord transperitoneale permettant l'exploration des deux surrenales. 5 patients ont presente une complication post-operatoire dont une splenectomie d'hemostase. Il n'y a pas eu de deces. Le taux de patients definitivement gueris a ete de 64% et celui des patients gueris et/ou ameliores a ete de 85% avec un suivi moyen de 32 mois. Ces taux sont similaires a ceux d'autres series analysant le traitement chirurgical de l'HAP

Forty-eight hours after a women was poisoned by ingesting Amanita phalloides mushrooms, she developed fulminant hepatic failure with collapse, pH 7.24, lactic acidosis 7.6 mmol/l, hypoglycaemia 3.5 mmol/l, anuria and stage IV coma requiring tracheal intubation and mechanical ventilation. Transaminase level was up to 8,000 UI/l. Prothrombin and factor V levels were below 10 percent, with an APT time of 86 s versus a 29 s control time. Twenty-four hours after her admission, the patient underwent orthotopic liver transplantation. The postoperative period was uneventful, with return to consciousness and rapid normalization of hepatic biochemistry values, without signs of acute rejection. This 10th published case of orthotopic liver transplantation for Amanita phalloides poisoning with acute hepatic necrosis confirms that this type of treatment must be systematically envisaged in all such cases.

Forty-eight hours after a woman was poisoned by ingesting Amanita phalloides mushrooms, she developed fulminant hepatic failure with collapse, pH 7.24, lactic acidosis 7.6 mmol/l, hypoglycaemia 3.5 mmol/l, anuria and stage IV coma requiring tracheal intubation and mechanical ventilation. Transaminase level was up to 8 000 Ul/l. Prothrombin and factor V levels were below 10 percent, with an APT time of 86 s versus a 29 s control time. Twenty-four hours after her admission, the patient underwent orthotopic liver transplantation. The postoperative period was uneventful, with return to consciousness and rapid normalization of hepatic biochemistry values, without signs of acute rejection. This 10th published case of orthotopic liver transplantation for Amanita phalloides poisoning with acute hepatic necrosis confirms that this type of treatment must be systematically envisaged in all such cases.

The intrapericardial approach to the inferior vena cava can be a useful manoeuvre in some hepatic transplantations.

271 exereses pour cancer epidermoide de l'œsophage ont ete realisees entre 1974 et 1981. Les complications respiratoires postoperatoires avaient une frequence de 19,5% avant 1978 et de 6,8% apres 1978, la ventilation postoperatoire controlee etant devenue systematique