Gastrojejunocolic fistula is a late complication of gastroenterostomy and is associated with inadequate gastric resection and incomplete vagotomy. In the past, attempted primary repair had high mortality and staged operations were normally performed. We present two cases of gastrojejunocolic fistula and discuss the modern management of this condition. In both cases, improved nutritional support allowed successful one-stage surgical repair to be performed.

The prenatal diagnosis and perinatal outcome of two patients with isolated foetal ascites compatible with chyloperitoneum is described. The foetal ascites resolved spontaneously after delivery with good perinatal outcome in both cases. A good prognosis can be anticipated in such cases. Antepartum and intrapartum interventions are seldom necessary.

A 75-year-old man developed an incisional hernia over the upper abdomen following a wedge resection of a gastric stromal tumour in 1996. This is the first published report of a successful repair of an incisional hernia via a laparoscopic intraperitoneal on-lay technique using GORE-TEX DualMesh material in Hong Kong. Compared with conventional open repair of incisional hernia, long incisions and wound tension are avoided using the laparoscopic approach. This translates into a reduced risk of wound-related complications and facilitates recovery. In selected cases, minimally invasive surgery is a safe technique for the repair of incisional hernias.

Two cases of subclinical and undiagnosed thyrotoxicosis that presented with unexplained tachycardia during surgery are described. Differential diagnosis and logistics in the management of patients presenting with tachycardia, with or without fever during anaesthesia are discussed. It is emphasised that when encountering unexplained tachycardia during anaesthesia, thyrotoxicosis must be suspected. Investigations for thyrotoxicosis must be carried out in the postoperative period.

Septic metastatic endophthalmitis is a rare but serious disease. Endophthalmitis arising from Klebsiella pneumoniae liver abscess has been reported with diabetes mellitus as a major associated condition, but is rarely seen in patients without diabetes. A non-diabetic patient with liver abscess complained of right eye discomfort and floaters 3 days after admission. Both blood and liver aspirate cultured Klebsiella pneumoniae . The patient was treated initially with systemic and subconjunctival antibiotics followed by intravitreal antibiotics with successful visual salvation. Previous reports from the literature showed poor visual outcome despite treatment and delayed recognition was often the cause. Clinicians should be alert to endophthalmitis whenever a patient with Klebsiella pneumoniae liver abscess complains of ocular symptoms. Urgent ophthalmological assessment should be sought.