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The Mayer-Rokitansky syndrome is a spectrum of mullerian anomalies, including vaginal agenesis with or without renal anomalies, in genotypic and phenotypic female subjects with normal endocrine status. We describe the management of a patient with this syndrome. We also propose a modified corrective method of the vaginal agenesis by a partial skin grafting.

Conservative management of distal gastro-intestinal bleeding is successful in most cases; 10% of patients hospitalised with this diagnosis will however undergo emergency surgery. Preoperative localisation of the bleeding site allows to perform a limited, segmental colectomy even in emergency. This has been shown to be associated with a lower operative mortality and morbidity when compared with subtotal colectomy. In this retrospective study we reviewed the notes of 134 patients admitted with lower gastro-intestinal bleeding. 22 of these required more than 4 units of blood transfusion and 12 underwent emergency surgery. Preoperative localisation of the source of bleeding was possible in 7 cases (58%); the remaining 5 underwent a subtotal colectomy. The operative mortality was 8%. The Authors emphasise the importance of an aggressive diagnostic work up in all cases of massive bleeding (i.e. more than 4 units of blood requirement in the first 24 hours following hospitalisation) in order to minimise the number of emergency subtotal colectomy.

The best method for inguinal hernia repair has not yet been established in the literature. Good results have been reported with Shouldice repair. This method includes both the posterior and the anterior layers of inguinal wall. The British method known as "nylon darn" has shown to be effective in preservation of deep groin anatomy. The author suggests the association of both methods to achieve the strength of the wall and the preservation of the groin anatomy.

A 22-year-old woman underwent thyroid lobectomy for papillary carcinoma (follicular variant). Local recurrences 4 and 7 months later, with vascular invasion and extrathyroid spread, required extensive surgery and radiotherapy. Ipsilateral lobectomy with near-total or total contralateral lobectomy is advocated for treatment of papillary thyroid cancer.

Three patients presented with parotid masses which revealed, on frozen section, to be metastatic lesions from malignant melanoma. Their medical history confirmed that the removal of cutaneous lesions of the frontal, temporal or eyelid skin had been performed presumedly without histologic examination. Disease staging was assessed as p-T0N1M0. Parotidectomy was performed in all cases without complications, and DTIC was given in one case. One patient died six months after surgery for metastatic disease, another one died disease-free, the third is available for the follow-up. The Authors recommend parotidectomy for prophylaxis in malignant melanoma more than 0.75 mm in thickness which is within a few centimeters of the parotid gland area. Lymphoscintigram might be useful occasionally.