During the five‐year period from 1963 to 1968 there were 327 elective cholecystectomies, and 128 cholecystectomies carried out during an attack of acute cholecystitis. The patients in the acute group were significantly older than those in the elective group. The operative mortality was 1.2% in the elective group and 1.6% in the acute group. The only significant difference in the incidence of complications was that temporary biliary fistula which occurred only in the acute group.
Reports of two unusual cases of obstructive caecal perforation are presented, and the relevant literature is reviewed. It is suggested that the prime factor in obstructive caecal perforation is ischtemia. The importance of recognizing and treating impending perforation of the caecum in large‐bowel obstruction is emphasised. Caecostomy is recommended for small perforations, but resection is indicated if more extensive ischcemia is present.
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