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Thirty-four patients with bilharzial granuloma of the gastro-intestinal tract were analysed. The commonest site was the rectosigmoid. Bilharzial ‘appendicitis’ was also common but the exact relation between bilharzial granuloma and acute inflammation remains unclear. Preoperative diagnosis of bilharzial granuloma is occasionally dificult and histological proof is necessary. Surgical treatment with polypectomy in the case of a solitary polyp and excision of the affected segment of bowel when there are multiple polyps are recommended, There is no evidence that the conditon is premalignant.

The case is reported of n 10-year-old boy who had severe diarrhoea with blood and mucus for I year which was found to be due to bilharzial polyposis of the rectum and sigmoid colon. He was treated first with anti-bilharzial drugs. Later, because of multiple polyps and secondary infection, local surgical resection was performed.

Three cases of familial polyposis coli with adenomatous polyps of the upper gastro-intestinal tract are reported. This association has not previously been described in Britain, probably because no special attempt has been made to detect polyps in these situations. A careful study of known cases of polyposis coli is required to establish the frequency and fate of associated gastric or small intestinal polyps, with particular reference to the risk of malignant degeneration and the possibility of prophylactic surgical measures.