A case of acute small bowel obstruction is presented occumng five months after blunt abdominal trauma due to a seat-belt injury. The problem of early diagnosis is discussed. With the increasing use of seat-belts, clinicians should be aware of this condition as part of the 'Seat-Belt Syndrome'. Histopathology of the affected segment of ileum was found to closely resemble Crohn's Disease.

A patient who developed multiple metachronous gastro-intestinal carcinoma is described. This patient has had multiple invasive carcinoma of the colon, jejunum and stomach over a 34 year period, commencing at the age of 44 years. All the colonlc tumours have been Duke's A Grade, although penetration has occurred to the serosal level. The family pedigree of the propositus shows an autosomal Mendelian dominant gene pattern with a characterlstic early age of onset and a significant frequency of multiple metachronous primary malignant neoplasms. Identification of this syndrome provides an opportunity to include In a surveillance program, those unaffected patients in the pedigree who have an extra risk of early development of cancer at specific sites.

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of Carcinoma of the Body Treated with Radiotherapy Two patients are reported illustrating the early and late rectal complications of radiotherapy used in the treatment of carcinoma o f the body o f the uterus. The first developed a florid proctocolitis during a course of intracavitary and vaginal radiotherapy. This was followed by rectal stenosis requiring a one-stage anterior resection. The second presented zerith a rectal stenosis and a vesicorectal fistula ten years after radiotherapy. She w a s treated by a two-stage anterior resection, with an excision of the fistulous tract and repair o f the bladder wall. The pathogenesis of radiation-induced rectal stenosis is discussed, the literature is reviewed, and the cwrent concepts in management are outlined.Address for reprints: Lister House, 146 Baillie St, Horsham, Victoria 3400.A c s r .