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A retrospective study of 112 patients with acute obstructive carcinoma of the colon (added to 16 prospective recent cases), whose mean age was 74 years, with metastasis or peritoneal carcinosis in 23% of the cases, shows a high operative mortality (38.4%), an average survival of 804 days and a five years survival actuarial rate of 17.5%. 80% of further deaths were due to cancer. These results and the data of literature encourage the authors to suggest, whenever a curative resection is to be considered, a decompressive proximal colostomy combined to a short investigating laparotomy, followed by a two-stage resection 2 or 3 weeks later.

Among 67 blunt hepatic traumas treated during a 4 years period, 34 required an emergency surgery for reasons of severe bleeding, with 16 deaths of which 11 were directly due to the liver injury. 33 patients, whose hemodynamic stability contrasted with major hepatic lesions (5 deep fractures, 28 central hematomas combined with 5 subcapsular hematomas and 3 multiple parenchymatous fractures), were subjected to nonoperative management. One patient died from sudden hemorrhage and a second one underwent further drainage for a residual pelvic abscess. In the 32 alive patients, a close watch over with ultrasound and CT scan gave prominence to a complete disappearance of the lesions within 4 to 24 weeks. The nonoperative management of such hepatic injuries may be a safe and reasonable alternative to a high risk surgery, as far as the hemodynamic condition or associated visceral lesions do not require an emergency surgery.