Crohn's disease of the small intestine is usually managed by medical therapy with surgery being reserved for obstruction or fistula formation. A patient is described who developed small bowel obstruction due to an adenocarcinoma of the ileum after over twenty years of medical therapy for Crohn's disease, originally diagnosed at a laparotomy for acute abdominal pain. The possibility of malignancy in such long-standing disease should be considered.
715ulceration, however, would seem to make the addition of vagotomy to a gastrojejunal by-pass procedure a rational approach to the surgical management of these cases. SUMMARY A case of symptomatic annular pancreas in an adult male is reported and the literature reviewed.Acknowledgements.-We wish to express our thanks to Mr.
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