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• The records of 886 patients who had appendectomy performed by the same surgeons within a five-year period were used to contrast appendiceal stump inversion vs simple ligation. Our analysis contrasted inversion vs simple ligation techniques as related to postoperative complications, hospital stay, and pathologic diagnosis. Adhesions requiring repeated operation to relieve bowel obstruction occurred in five of 87 patients with acute gangrenous appendicitis treated by inversion. Of 106 patients with acute gangrenous appendicitis treated with simple ligation, postoperative obstruction developed in none. No other statistically significant differences existed between the two techniques. These data suggest that simple ligation is at least as good as and probably better than inversion of the appendiceal stump. (Arch Surg1988;123:689-690)

To the Editor.— Rupture of pacemaker batteries is rare. Mercury-zinc batteries, used to power early pacemakers, have largely been replaced because their warranties lasted only three years. We believe ours is the first reported case of spontaneous rupture of an implanted mercury-zinc pacemaker battery. Report of a Case.— A 62-year-old man who had a ventricular-inhibited demand pacemaker placed in August 1978 for complete heart block arrived at the emergency department complaining of sudden swelling and pain over the pacemaker site. At 2 AM the patient was awakened by what he described as an "explosion" in his chest. Physical examination showed an elderly man in mild distress. His vital signs were normal except for a temperature of 38 °C (101 °F). The pacemaker site was swollen and erythematous, and the overlying skin was warm. Physical examination showed no other remarkable findings. A chest x-ray film showed fragments outside the epoxy casing