The purpose of this study was to determine the place of selective renal angiography in the assessment of major renal trauma. Thirty‐one cases of renal injury assessed by urography and angiography were reviewed, and the radiological features correlated with the subsequent clinical course. Based on the angiographic findings, a classification of these more severe injuries is proposed, and the prognostic significance of renal ischæmia demonstrated. Because conservative treatment in those cases with significant ischæmia is likely to fail, early elective surgery is recommended. In this selected group, viable renal tissue can be preserved, and the necessity for subsequent nephrectomy due to secondary hæmorrhage, or continuing urine leakage, is avoided.

ddenornrctnonin of the appendix commoiily presents as oppendicitis and in nltrlrg irrstnnccJ is itot rccognized ntncrosropically b y either the siirgeoiz or the pathologist Iiriprovcd prognosis has been shown to follow right hewtnicolectomy in preference to siwttplc oppcndicertoniy. Histological section of all appendices removed from pntieiits ;it tlir susceptible age-qroup is therefore nzandatory.CARCINOMA of the appendix was classified by Uihlein and McDonald (1943) into a carcinoid type (88%) ) , a cystic type (mucocele, 8%) annl a colonic type (49%). The carcinoid tuniour has I)een well dociiiiiented previously and has a relatively henigti course. The malignant mucocele antl the colonic types are each histological variants of adenocarcinoma. They will he considered together, though the former tends to have a more favourable prognosis. Adenocarcinnnia of the appendix is a rare condition, being seen in 0.08% (Collins, 1955) t o 0.3% (Hyman. 1950) of all appendicectomy specimens. However, when treated by appetitlicectomy alone it has a five-year survival rate of only 20% (Edmondson ancl Hobbs, r967 : Hesketh, 1963). Several recent cases of at1enoc:ircinoma were recognized only on hirtoloqical examination following appendicectomy for cla5sical appendicitis. A review of the cases sern at Royal Melhourne Hospital over the last ten years was therefore conducted. METHODThe ncpartnirnt of Pathologv reports of appendices seen over the period from 1963 to 1973 were reviewed.There were 3.989 appendices sent for pathological examination over this periotl, and 13 adenocarcinonias were fomnd.In the early years under review the specimens were examined macroscopically by the pathologist, and if obvious signs of acute itiflainmation were present, without suspicion of tuniour. the appendix was not sectioned. If the organ showed no signs of inflammation or ' Surgical Registrar.