Seven gastrocolic and five gastrojejunocolic fistulae were recorded at Charity Hospital between 1940 and 1970. Such fistulae occurred in males more often than females. In this series, as in others, the most common cause was gastric surgery for peptic ulcer disease. Pain, diarrhea, and weight loss were clinical findings in half the patients; anemia, leukocytosis, electrolyte disturbances and hypoalbuminemia were common laboratory findings. A fistula was demonstrated radiologically in nine of the twelve patients, management of these patients included no operation (3); two-stage procedure (2); and one-stage procedure (7); with a recent trend toward the one-stage procedure. A case report of a fistula resulting from postoperative complications of perforative appendicitis in which a successful combination of hyperalimentation and diverting colostomy was used is presented.

Background: Abducens nerve (Cranial Nerve VI) innervates the lateral rectus (LR) muscle. Head trauma is one of the most common causes of abducens nerve palsy. Orbital and/or facial injuries could also affect the LR muscle directly or the orbital course of abducens nerve and lead to palsy. We present a case of a young man with multiple orbital fractures and an impingement of the LR muscle resulting in a complete loss of abduction. Case Report: A 29-year-old male reported falling 15 feet. He presented with diplopia and had complete abduction deficit of the left eye. Orbital CT imaging revealed a bony spur from his left zygomatic bone impinging on the lateral rectus muscle. In view of –4 abduction deficit, he was operated upon to remove the bony spur. This led to a gradual, but complete recovery of his abduction. Discussion: The abducens nerve has a tortuous course and as a result is commonly injured during head trauma, in particular due to its vulnerability as it passes into Dorello’s canal, or its journey through the cavernous sinus. The case report highlights orbital causes such as direct muscle avulsion or injury to the orbital portion of the abducens nerve, as reasons for how LR weakness could be easily overlooked, unless specifically examined with high-resolution orbital imaging. Conclusion: Orbital mechanical causes can be overlooked in LR palsy. We emphasise the role of orbital imaging in any patient with abducens nerve or LR Palsy and reaffirm that not all cases are associated with an intracranial cause.