Anastomotic ulcer: an unusual cause

A case of recurrent stomal ulcer is reported due to retained excluded antral mucosa during a Bancroft procedure. The diagnosis was suspected from the severity of the ulcer diathesis, and the elevated basal acid secretion despite previous trans-thoracic vagotomy and repeated gastric resection. It was confirmed by finding retained antral mucosa in the "duodenal" stump, and a normal pancreas at operation; and by a marked fall in acid levels following antral excision.The diagnosis and treatment of this condition are discussed. Continual awareness of retained excluded antrum as a cause of stomal ulcer will decrease the frequency of this complication and ensure prompt diagnosis and treatment when it occurs (AU)

Spontaneous rupture of the liver in pregnancy

A case of spontaneous rupture of the liver is presented, including the first English Language report of hepatic resection for this condition. The aetiology, pathogenesis, diagnosis, and treatment is reviewed. Hepatic artery ligation, evacuation of the subcapsular haematoma, excision of Glisson's capsule and drainage is suggested as the best initial approach. Hepatic resection is reserved for patients in whom this fails (AU)