Deep wound infection of the abdominal wall and postoperative abdominal wound rupture are dangerous complications of laparotomy that require emergency operative intervention. The wound infection quota after laparotomy is between 5 and 10%. While subcutaneous infections heal without consequences after wound treatment, deep infections of incisional wounds are a problem. The cause is often an intra-abdominal infection. There are some standard operational measures: consistent debridement of the necrotic parts, careful re-exploration of the intra-abdominal site and early fascial closure with special sutures. All other procedures depend on the individual case. Abdominal wall rupture only occurs in 1% of the cases, but the mortality is high (15-45%). Besides local wound factors and the technical aspects, there a many general causes. Abdominal wall rupture also requires emergency operation. Repeated wound closure without further steps is possible in half of the cases. The mass technique should be used. Both deep wound infections and rupture are important complications in the development of incisional hernias.

A case of brachial artery rupture following compound dislocation of the elbow is reported. Arterial injury is a well‐known complication of a supracondylar fracture of the humerus, but is very rare in association with elbow dislocation. A reversed saphenous vein graft was used for treatment of the arterial injury and is the recommended method of management.

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Unsuspected Carcinoma of the Gallbladder following Cholecystectomy In 36 out of 123 patients with gallbladder cancer who were treated between 1973 and 2000 in the Vogtlandklinikum Plauen, the diagnosis was put only by postoperative histological investigation. 22 patients were diagnosed as stage I and II, and 14 were assigned to the prognostically unfavorable stages III and IV. 15 patients were provided for a radical second operation (7 patients in stage I/II, 8 patients in stage III). Only 5 patients in stage I/II and 2 patients in stage III/IV survived for a longer time than 2 years. The inadequate possibilities of early diagnosis remain the decisive problem in the treatment of gallbladder cancer. An extended diagnostic could improve the prognosis in risk patients (female patients of higher age, multiple or large gallstones, long symptomatic gallstone suffering). Because the operation represents the only curative chance, a radical second operation is indicated in the case of an incidental diagnosis. Extensive resections should only be carried out if the possibility of a curative operation is given.