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A vascular interruption to the azygoportal zone, achieved by devascularisation about the cardia and a closed transmural ligation of the varices is described, which is combined with a simultaneous truncal vagotomy, pyloroplasty procedure and a fundoplication. This fourfold method combats the bleeding varices at several points: a direct disruption of vascular paths, haemodynamic control, reduced influence of peptic factors, the management of coincident ulcer pathology and the prevention of gastro-oesophageal reflux. The results from 5 patients are encouraging. This abdominal operation is swift, comparatively atraumatic and may be undertaken in emergency cases and in at-risk patients on an elective basis.

Small intestine perforations caused by systemic disorders are, except with M. Crohn, extremely rare. Therefore we report two cases of "spontaneous" small intestine perforations: one with hypersensitivity angiitis and one with Moya-Moya-disease, the latter not yet described in the literature.

Two series of 50 consecutive elective colonic resections with bowel preparation either with Neomycin (group A) or Neomycin combined with Metronidazole (group B) are presented. 17 bacterial inflammatory complications in group A versus 10 in group B were noted. It is concluded that the addition of an antianaerobic antibiotic agent in elective colonic surgery might be of beneficial effect.

4 cases of postoperative subhepatic abscess formation after cholecystectomy are reported, where absorbable hemostatic agents for control of bleeding had been used. The etiology of these complications is discussed. The use of local hemostyptica is strongly disadvised in all possibly bacteriologically contaminated procedures.

Aetiology of colonic perforation is reviewed and discussed. 8 cases of "spontaneous" ileo-colic perforations observed between 1975 and 1977 are presented. Two of these patients had recently undergone appendectomy, and 4 others showed a simultaneous distal carcinoma of the large bowel. Histo-pathological evaluation did not reveal the cause of intestinal perforation. Operative treatment and results are given.

A case of discrete, localised Morbus Ménétrier is reported, with pitting of a giant mucosal fold at the antrum, where the patients' main symptom was recurrent gastric haemorrhage. The presentation posed considerable diagnostic difficulties that were only clarified through a partial gastric resection and subsequent histological examination.

A prospective study concerning 100 consecutive cases of colonic resections and anastomosis with single layer sutures is reported where radiological controls 10-12 days postoperatively had been carried out. An anastomotic insufficency was recognized clinically in 15%; in 6% a small leakage was only detectable radiologically. 50% of all anastomotic deficencies were seen in cases with preexisting perforation peritonitis or ileus, especially if an emergency resection had been necessary due to septic complications. 3 out of the 7 deaths were connected with dehiscence in the suture line.

6 cases of colonic endometriosis, treated by surgery, are presented. The average age was 50 years. All patients also had concomitant genital endometriosis and 5 of these 6 women have had previous pregnancies. Pathological findings were intramural colonic growth leading to stenosis and tumor like endometriomas. 3 times a sigma resection, once an ileo-cecal and once an anterior resection was carried out, there is in one instancy the stenosis could be overcome by enucleation. Postoperative course was uneventful, but one case later on developed a rectal carcinoma--first mistaken as recurrence of intestinal endometriosis.