tional surgical approaches to this problem are discussed. A technique for laparoscopic repair of a Morgagni hernia is described. The literature on the laparoscopic repair of a Morgagni hernia is reviewed and different operative techniques are discussed.

This study indicates that the volume of liver ablated by RF can be increased by augmenting the IPP. Our data support the theory that a decrease in portal blood flow results in decreased heat dissipation during RFA. The laparoscopic approach to RFA offers the advantage of allowing control of the IPP, which may result in a larger volume of ablated tissue per treatment than can be achieved with the percutaneous technique. These preliminary data on normal hepatic tissue must be confirmed clinically in the setting of hepatic tumors.

The case of a patient with acid burns of the large bowel from a self-administered enema of 95 percent sulfuric acid solution is reported. The authors were unable to find a similar case in the English medical literature. The patient presented in metabolic acidosis, and flexible sigmoidoscopy was of limited value. Peritoneal signs warranted early laparotomy, which revealed coagulation necrosis of the anus, rectum, and colon up to the hepatic flexure without any free perforation. The extent of damage was more severe than seen in the upper digestive tract from acid ingestion. Juxtaposed small bowel and the appendix sustained serosal burns. Subtotal proctocolectomy and perineal resection were done and the patient made an uneventful recovery. Early laparotomy is warranted, irrespective of endoscopic findings, for appropriate surgical correction.