Background. Tamoxifen has been used extensively as adjuvant therapy in the treatment of pre‐ and postmenopausal patients with breast cancer. One of its known complications is venous thromboembolism. However, arterial thrombosis has been reported rarely. Methods. A 49‐year‐old patient with breast cancer had had a total mastectomy 3 years earlier. She was receiving tamoxifen therapy when she developed a sudden onset of pain and numbness of the left foot and calf. An arteriogram showed thrombosis of her tibial arteries. Results. This thrombosis was lysed successfully with urokinase therapy, and tamoxifen therapy was discontinued. At follow‐up 4 months later, the patient had normal circulation to both legs. Conclusions. Patients receiving tamoxifen should be monitored closely for the development of venous or arterial thromboembolism. Cancer 1995;76:1006–8.

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A case of adult necrotizing enterocolitis which occurred following subtotal pancreatectomy for advanced chronic pancreatitis is presented. Multiple perforations of the colon, ileum, jejunum, and duodenum were identified, associated with rod-shaped organisms in the tissues. Clostridium perfringens, which secretes a beta toxin known to cause necrosis of the intestine, was cultured from blood, sputum, and peritoneal fluid. Neutralization of beta toxin by proteolytic enzymes failed to occur due to poor exocrine function of the pancreas. This resulted in the manifestation of enterocolitis. A search of the English literature indicates that there has not been a previously reported association of adult enterocolitis and chronic pancreatitis.

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Ankle-arm index (AAI) and pulse volume recording (PVR) are commonly used in the early postoperative period to measure the outcome after lower-extremity revascularization. They are also used in addition to duplex scan for long-term follow-up of these patients. We noticed that in some patients the AAI and/or PVR after revascularization procedures did not improve immediately after surgery, but took 24 hours or longer to do so. We retrospectively reviewed the records of 47 patients who underwent various lower-extremity revascularization procedures and found that out of 20 patients who had AAI and/or PVR measured in the recovery room, 8 patients took 24 hours and 1 patient took more than 24 hours for maximal improvement of their AAI and/or PVR. This may be related to vascular spasm, and knowledge of this delayed improvement is important in preventing errors during follow-up.