These results indicate that increased experience decreases the risk of pouch-related complications and that with time the functional results remain stable, but the failure rate increases.

ObjectiveThe authors determined whether Meckel's diverticulum, discovered incidentally at operation, should be removed. Summary Background DataIt is not clear from the medical literature whether the risk of an incidental Meckel's diverticulectomy is greater than the risk of leaving the diverticulum in place. MethodsThe authors used the medical experience of Olmsted County, Minnesota residents for the period 1950 to 1992 to answer the question. ResultsDuring the period, 58 residents developed Meckel's complications that required diverticulectomies. The incidence of complications was 87 per 100,000 person-years, and the lifetime risk (to 80 years of age) of developing them was 6.4%. The risks were similar throughout the period and at all ages of life, but were greater among men (124 per 100,000 person-years) than women (50 per 100,000 person-years, p < 0.05). Diverticulectomies for complications carried an operative mortality and morbidity of 2% and 12% and a cumulative risk of long-term postoperative complications of 7%, whereas incidental diverticulectomies done in 87 residents during the period carried corresponding rates of only 1%, 2%, and 2%, respectively. ConclusionsMeckel's diverticula discovered incidentally at operation should be removed for most patients, regardless of age.Meckel's diverticulum is the most common congenital abnormality of the gastrointestinal tract, affecting 2% of the general population.1 2 Although this prevalence fig-

The objective was to explore the hypothesis that the proximal stomach has a major role in gastric emptying of liquids and the distal stomach a major role in gastric emptying of solids. The results of experiments on the intact stomach and on the stomach after selective resections, denervations, and during hormonal infusions are, in general, consistent with the hypothesis.

Hypothesis: To review our experience with the treatment of patients with nontraumatic spontaneous intramural small-bowel hematoma. Our hypothesis was that this condition resolves spontaneously in most patients.Design: A retrospective review of the records of 13 patients with nontraumatic spontaneous intramural smallbowel hematoma who presented to Mayo Clinic (Roch-

The aim of this study was to determine the long-term outcome among 390 patients with ulcerative colitis who underwent ileal J pouch-anal anastomosis and whether patient or operative factors influenced results. The combined operative morbidity rate for the pouch-anal anastomosis and the subsequent closure of the temporary ileostomy was 29% (bowel obstruction, 22%; pelvic sepsis, 5%), with one death due to pulmonary embolus. The probability of a successful outcome at 5 years was 94%. Of the 24 patients who failed (6% of total), 18 did so within 1 year (4%), three during year 2 (1%), three during year 3 (1%), and none thereafter. Stool frequency (7 stools/24 h), the occurrence of pouchitis (14%), and satisfactory daytime continence (94% of patients) remained stable over 4 years after operation, whereas nocturnal fecal spotting decreased (51% of patients to 20%). Women had more spotting than men, whereas patients over 50 years old had more stools per day than those 50 years or younger. In conclusion, ileal pouch-anal anastomosis achieved a reasonable stool frequency and satisfactory continence in patients with ulcerative colitis over the long-term. These results support the ileal pouch-anal anastomosis as a safe, satisfactory alternative to permanent ileostomy.