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Of these, 27 (25.2%) were aged 60 years and above, all females, mean age 66.3 years. Only two patients (7.4%) presented with early breast disease (stages I and II), the rest presented with late disease (stages III and IV). Duration of symptoms before presentation was between six weeks and tllree years (mean 15 montlls). Histology in all cases revealed invasive ductal carcinoma ranging f i~m tlle well differentiated to the poorly differentiated varieties. Twenty patients had mastectomy, while seven had radiotherapy. All patients had adjuvant chemotherapy and tamoxifen. Eight patients (29.6%) were 10s t to follow-up. Of t l~e remaining 19 patients, 10 (52.6%) were officially recorded to have died within the period under review. Health education of the elderly and physician vigilance are keys to early detection and treatment of breast cancer in the elderly.

We report a prospective study of 17 cases of enterocutaneous fistulae managed at the University of Benin Teaching Hospital, Benin City, Nigeria between June 1992 and June 1999. All the cases were iatrogenic in origin and all age groups (6 weeks to 68 years, mean 27) were represented. There were 10 males and 7 females. Emergency surgery for acute appendicitis and intestinal obstruction were the commonest causes. Management should be conservative initially but surgery should be resorted to if there is no significant improvement, particularly in circumstances where facilities for total parenteral nutrition are not available. A literature review has been carried out and measures to prevent the development of enterocutaneous fistula are outlined.

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