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Between 1970 and 1973 1333 patients with suspected appendicitis were seen at the University Hospital of Basle. Operations were performed on 87.5%, of whom 89.8% proved to have appendicitis. The incidence of perforation was 13.5%. A five-year follow-up study was carried out on 100 cases dismissed without operative revision and appendectomy. Of these patients 20 later had an appendectomy and 42% did not approve of the conservative attitude. The high rate of secondary appendectomies within 5 years seems to advocate liberal indication for appendectomy if appendicitis is considered.

For many of today's clean-contaminated surgical operations antibiotic prophylaxis is a generally accepted and proven procedure. On the basis of a literature survey the parameters to be considered are analyzed: bactericidal spectrum, pharmacokinetics (peak plasma and tissue concentrations, tissue penetration, persistence at high-risk sites and elimination), minimal toxicity, absence of (above all, serious) adverse drug reactions (coagulation disorders, etc.), avoidance of resistance, suitability for single-dose prophylaxis even when the operation is unforeseeably delayed after the administration of the antibiotic, or when the operation lasts a very long time. Finally, the antimicrobial chosen must be cost-effective. The decisive factor, however, remains the proven clinical efficacy for the procedure concerned. There should be no prejudging of any issue until the relevant data have been collected, especially in the case of facts suggesting that single-dose antimicrobial agents are effective even in colorectal surgery, and that cephalosporins of the third generation might offer advantages over those of the first.

100 consecutive colonic resections for carcinoma are reported. The average age was 67.5 +/- 10.8 years. In 93% of all cases primary resection without colostomy was carried out. The overall operative mortality rate was 1% and the mean hospitalization period 19.8 +/- 7.3 days.

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.

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.