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Ischaemic colitis was not diagnosed until laparotomy in five cases. In two it was secondary to hypotension and multiple organ failure, in two it was atherosclerotic, and one had polycythemia vera. The diagnosis should always be considered in patients with abdominal distension--with or without diarrhoea and abdominal pain--so that treatment may be instituted before the onset of peritonitis.

Cholecystokinin (CCK) was used in a randomized double-blind trial to evaluate its effect on post-operative paralytic ileus. Sixty patients were admitted to the study. The return of postoperative intestinal motility was registered with subjective and/or objective methods. No differences were found between the CCK group and the placebo group.

A case of gastric carcinoid tumor in a patient with pernicious anemia is presented. From a pathophysiological point of view, the treatment of choice, i.e. endoscopic removal or gastric resection, is discussed.

Six anesthetized dogs were administered three consecutive 30 min infusions of substance P in increasing doses of 1.0, 2.5 and 20 ng kg(-1) min (-1). Five anesthetized dogs were administered 10 min infusions of somatostatin, 0.2 and 1.0 microgram kg(-1) min(-1). The dogs were provided with a common duct fistula and the cystic duct was ligated. The output of total bile, bile acids, sodium, potassium, chloride and bicarbonate was studied in 10 min fractions. Substance P at a dose of 2.5 ng kg(-1) min(-1) and above, reduced the output of total bile, sodium, potassium and chloride by a maximum of 40%, indicating an inhibition of the bile acid independent fraction. The output of bile acids and bicarbonate was unaffected. Both doses of somatostatin reduced all parameters studied by a maximum of 25-45%, indicating inhibition of the bile acid dependent, the bile acid independent and the ductular bile secretion.

A patient with massive hematemesis due to an aorto-oesophageal fistula is presented. An aorto-oesophageal fistula is mostly a fatal disease. In the literature it is pointed out that recognition of the clinical syndrome with midthoracic pain, massive arterial hemorrhage and exsanguination after a symptom-free interval might ameliorate the prognosis. In the reported patient the correct diagnosis was not immediately suspected. The patient, however, survived a long operation and exsanguination without any major postoperative complications or sequelae.