at our institution were enrolled in the study.Main Outcome Measures: P-POSSUM and Cr-POSSUM scores were calculated for each patient. Inhospital mortality rate and number of deaths within 30 days after surgery were recorded. The ratio of observed to expected deaths was calculated for each analysis.Results: The P-POSSUM system underpredicted mortality by 25%, with no significant difference between the predicted and observed values (P=.96). The observed to expected ratio for Cr-POSSUM was 1.11, with no significant difference between the observed and predicted values (P=.19). Area under the receiver operating curve for P-POSSUM was 0.70 and for Cr-POSSUM was 0.59.Conclusions: Both P-POSSUM and Cr-POSSUM perform well in predicting mortality after colorectal cancer surgery, but the Cr-POSSUM is more accurate. There is a constant need for reevaluation of existing and any new scoring systems outside original development and validation populations. The Cr-POSSUM score is a promising specialized tool for monitoring surgical outcomes in colorectal cancer surgery.

We present a case of a 58-year-old man who was admitted to our hospital because of abdominal pain. He underwent incisional ventral hernia repair with intraabdominal mesh (ePTFE). On the day of admission, physical examination included the discovery of a foreign body in the rectum. There were no signs of acute abdomen. We induced stool, and the mesh came out with it. His further course was uneventful. Gastrografin series showed persisting fistula between the small intestine and colon, but without extralumination into the peritoneal cavity. The patient was discharged in good health and without signs of incisional ventral hernia.

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About 50% of patients will present with potentially surgically curable disease. Patients who present with metastatic disease have a median survival of 18-24 months. 3 Disease usually metastasize to liver or peritoneal surface, and rarely to lymph nodes, hence extensive lymphadenectomy is not needed.After surgical resection with curative intent, median survival is 66 months. Forty percent of patients will develop recurrence with a median survival of 18 months and a 45% 5-year survival. 4 Traditional chemotherapy and radiotherapy are ineffective. Since 2001, imatinib (Gleevac) has revolutionized treatment for GIST patients with metastasis at initial presentation or recurrence after surgery. Although not curative, imatinib achieves disease control in 70-85% of patients with advanced GIST, with median progressionfree survival of 20-24 months.This case illustrates an unusual presentation of a GIST arising from a Meckel's diverticulum causing large bowel obstruction with a plain abdominal X-ray appearance of volvulus.