. Annales de chirurgie . -megacolon. L'injection de bismuth befo sigmoïde, ont été réséquées, le côlon descendant se hissant nnité à la méthode de la lie recto-sigmoïde d'une anastomose latérale. Au moment de l'opération, on a trouvé que le sigmoidcolon et le rectum étaient fortement dilatés et que les parois étaient dicirées. Le reste de l'intestin ajipeared légèrement dilaté butrelativement normal. Après avoir conqieting l'anastomose, un tube a été conduit de l'anus à travers le stoma dans la flexion splénique de tlie. (>83 COLECTOMIE PARTIELLE POUR LE MEGACOLON le traitement post-opératoire était sans incident et la blessure guérit après l'Union primaire, la petite da en caoutchouc

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. Annals of surgery . -Megacolon. Bismuth injection befo sigmoid, were resected, the descending colon heing nnited to the recto-sigmoid liy means of a lateral anastomosis. At operation the sigmoidcolon and rectum were found to be greatly dilated and the walls diick-ened. The remainder of the intestine ajipeared somewhat dilated butrelatively normal. After conqieting the anastomosis a tube was carriedfrom the anus through the stoma into tlie splenic flexure. (>83 PARTIAL COLECTOMY FOR MEGACOLON The post-operative course was uneventful and the wound healed byprimary union, the small rubber dam drain being carried out through astab wound. The boy was discharged from the hospital nineteen days. FC- 3-—Partial colectomy for megacolon. Bismuth injection eight months after opera-lion. The bismuth was completely eliminated in twenty minutes. after operation. Since discharge he has had no symptoms, has not misseda day at school and has gained 22 pounds in weight. His bowels areusually regular, but sometimes he goes three days without a movement, apparently from lack of inclination to evacuate his bowels. A bismuthinjection ( Fig. 3) was completely eliminated in twenty minutes. It is difficult to say whether such a condition is congenital or acquired.(.8:5 Nl.W YORK SURGICAL SOCIETY Possibly there is a congenital defect in the innervation of the lower howeltending to fecal impaction which resulted in dilatation and hypertrophyof the large intestine above. Certainly such patients afford quite aproblem, and operation is not to be undertaken lightly. The home condi-tions of this patient were investigated and operation decided on onlywhen it was evident that the usual palliative meas

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