Senior Lecturer in Surgery; University College of the West Indies Direct extragastric spread of carcinoma of the stomach to the liver, pancreas or anterior abdominal wall is familiar; and spread to the transverse colon with formation of a gastrocolic fistula is not excessively rare. Perforation of the stomach wall into the peritoneal cavity has been reviewed by Aird (I935) and further cases are reported by Feldman and Weinberg (1950). The following case, however, differes in that the first clinically significant extragastric spread was to the jejunum and duodeno-jejunal flexure. Case Report C. M., negro male, aged 6o years, attended the University College Hospital of the West Indies on July 24, I953. For two months he had been complaining of great weakness, constipation and Supplement 1950 to 1952. To subscribers 3/-net; to non-Telephone: EUSton 4282 (7 lines) subscribers 6/-net; postage 6d.