Necrotizing fasciitis in contused areas.

Four patients are presented who sustained blunt trauma and later developed necrotizing fasciitis in the areas of contusion, associated with the distant locus of sepsis. Three of the cases developed acute renal failure and later died. Early recognition of this condition allows prompt debridement beyond the margins of involved necrotic fascia, followed by wound inspection 8-hourly, and treatment with antibiotics, most recently third-generation cephalosporins, piperacillin, amikacin, and vancomycin.

Two unusual complications related to fibre-optic endoscopy. Case reports.

Two unusual complications related to fibre-optic endoscopy are described. In one case a pneumomediastinum occurred during gastroscopy with no evidence of perforation. The patient was treated conservatively and made an uneventful recovery.

Malignant insulinoma: the problems of tumour localization and management. A case report.

A case of malignant insulinoma in a Black patient is presented. An investigational protocol is suggested with a discussion of the newer techniques of pancreatic adenoma localization and the therapeutic measures available for the management of malignant islet cell tumours.