The rare finding of a cecal fecalith in an 8-year-old child is described together with a review of similar cases. These indicate not only the difficulty of diagnosis, but the dilemma faced by the surgeon at the operation.

Congenital auricular and preauricular sinuses, while seemingly trivial and often unnoticed or ignored, can give rise to troublesome symptoms if infection supervenes. Nine of 30 patients (30%) operated upon between 1969 and 1981 had postoperative recurrence, two of whom required two excisions. We would recommend aggressive treatment of infection followed by excision in 2-3 weeks before further infection can occur.

Since 1974, 56 children with a neuropathic bladder were selected for intermittent or indwelling catheterisation. Indications for catheterisation included incontinence, hydronephrosis, and/or difficulty with bladder expression. Good results were obtained in 70% of girls and 50% of boys. The catheter was abandoned in 7 children, mainly because of lack of cooperation from the parents. Deterioration occurred only in those children with both hydronephrosis and vesico-ureteric reflux prior to catheterisation. Of the latter group of children, 33% suffered upper tract deterioration, and we now consider vesico-ureteric reflux to be a relative contra-indication to catheterisation, except in those children with severe disabilities and deformities, in whom antireflux surgery or urinary diversion would be unacceptable or technically difficult. Indwelling penile catheters should not be recommended for boys, but catheterisation via a perineal urethrostomy may prove helpful in those unable either to catheterise themselves intermittently or to wear a penile appliance.