The patterns of presentations, diagnosis and management of gall bladder perforation are changing. But there is scope for improvement.

A method has been devised to calculate breast volumes from mammograms. This has been applied to mammograms from 42 women with breast cancer and 42 age-matched normal controls. No difference in breast volumes was noted. Images Fig. 1

There does not appear to be a significant difference in the rates of pancreatic fistula following either method of reconstruction. However, performance of an isolated Roux loop pancreaticojejunostomy entails a prolongation of operative time and more intraoperative requirement of blood transfusions.

Internal pancreatic fistulas should be treated initially non-operatively; if this is not effective, operative therapy should be considered without delay.

Twenty stricture-plasties have been performed for multiple tubercular strictures of the gastro-intestinal tract in 9 patients, who in total had 35 strictures. The procedure has been found to be safe, simple and effective in relieving obstructive symptoms. It does not appear to carry the disadvantages of entero-anastomosis or multiple and/or massive resections in cases of multiple tubercular strictures of the small bowel.