After the liver had been separated from the abdominal wall, to immobilize the liver for removal of the gallbladder an opening of about 0.5 cm. in the superior surface of the liver, just to the left of the falciform ligament and close to the margin of the liver, was found, from which a drachm or more of thick, yellow pus escaped. At this stage a large, thick fishbone, about 4 cm. long, was found on the towel on the abdominal wall, where it had been wiped out with the pus. It was then quite obvious what the cause of the pathologic lesion was.The fishbone had apparently passed point first through the pylorus and stuck in the duodenal wall opposite the pylorus, where it had caused a duodenal ulcer, which had become adherent to the inferior surface of the left lobe of the liver near its margin. The fishbone had then perforated the intestinal wall and passed on through the liver, which had become adherent to the abdominal wall, and was probably well on its way through the abdominal wall when the operation was per-Roentgenographic shadow cast by fishbone perforating duodenum and liver. Inset: Length of bone on centimeter scale. formed. Separating the liver from the abdominal wall allowed