Complete rectal prolapse: repair by a simple technique.

A simple technique for the repair of complete rectal prolapse is described, and the results assessed. The method involves posterior rectopexy, suturing the rectum to the sacrum with paired interrupted linen sutures, thus avoiding the insertion of sheets of foreign material. The operation is suitable for all ages, and the minimal pelvic dissection required facilitates its use in high risk patients. The procedure was carried out in 23 patients, aged between 14 and 88, with a follow up period of between 2 months and 6.5 years. There was one postoperative death. The operation has a low morbidity and mortality, and the majority of the patients are now totally asymptomatic. There have been no recurrences of the complete rectal prolapse.

Massive embolism from cardiac myxoma.

Two cases of massive embolism from atrial myxoma are described. One of these patients survived aortic surgery, and this is only the third recorded survival of this condition. Pre-operative angiography is essential to successful management of these cases, and direct aortic surgery is the only way to remove these firm tumor emboli.

Haemorrhagic cholecystitis.

Two cases of haemobilia due to haemorrhagic cholecystitis are presented; only 28 other cases have been described. As there are so many more dramatic causes and treatment for haemobilia it is important for the surgeon to recognize that a common operation will suffice for this rare condition. In both cases bacteria were grown from the bile and it is to be hoped that bile culture will be recorded more commonly in future in cases of this interesting condition.

Gastrointestinal haemorrhage from small bowel duplication.

A case is reported of duplication of the small bowel presenting with gastrointestinal haemorrhage. This is the first reported case in an adult. A review of the literature has been made and the pathogenesis discussed.