Fistula formation as a complication of colonic cancer is relatively rare. Six cases of colonic cancer with gastrocolic, jejunocolic or clocolic fistulas underwent an en bloc resection in the authors' Department of Surgery, from January 1956 through August 1977. In every cases, the resected specimen showed a large advanced carcinoma originating in the left colon invaded the adjacent holeorgan by direct extension, forming a fistula at the central portion of cancer invasion between both the organs.
Microscopically, all the carcinomas were of low grade, and the fistulas were lined by different degree of necrotic or viable growth and inflammatory tissues.
Survival after an en bloc resection seems to bo related to the degree of anaplasia of a neoplasm and metastatic involvement in the regional lymph node.
In this series, all the 5 patients except recently operated one survived longer beyond expectation, and the longest surviving one is alive more than 9 years. Both the cases re-ported in the literature and of the authors themselves reveal the ratio of occurrence of a fistula in the left colon is much higher than in the right.

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The serial blood culture study was performed in the 48 patients who underwent minor anal operations.
Arterial blood cultures were obtained three times ; immediately after operation in the operating room, on the 1st postoperative day and the 2nd postoperative day in the ward. The media used were Culture-Bottle No. 1 and Culture-Bottle No. 2.
Blood culture was positive in only one of the 48 patients immediately after operation, Positive in two of the 46 patients on the 1st posteperative day and negative in all of the 32 patients on the 3rd postoperative day. Based on these findings, three of the 48 patients (6.25%) were diagnosed as postoperative bacteremia.
The bacteria obtained in these 3 cases were sensitive against all antibiotics available. All of 3 patients of bacteremia improved without antibiotics and did not progress to sepsis.

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A case is reported of carcinoma of the transverse colon complicated with a duode-nocolic fiistula and tuberculosis of the colon.
A 41-year-old woman was admitted for surgical treatment of a round, firm, relatively smooth mass in the right hypochondrium.
Barium enema revealed an annular filling defect in the transverse colon close to the hepatic flexure and two skip lesions with irregular mucosal surface seen distally.
Exploratory laparotomy was performed and the tumor mass could not be removed be-cause of presenting a large mass involving the duodenum and head of the pancreas. Two weeks later, the patient began to vomit fecal materials frequently and a duodenocolic fistula was proven radiographically.
At autopsy the carcinoma of the transverse colon involved the second portion of the duodenum forming a duodenocolic fistula and two skip lesions seen distally were histologically proven to be tuberculous.
No previous report of such a case has been found.

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Carcinoma of the colon is an exceedingly rare occurence in persons under 20 years of age. Only 21 of these cases have been reported in the Japanese literatures. Two additional cases were reported.
Case 1. A 19-year-old female with a complaint of bloody stool and pain in the left lower abdomen. Preoperative diagnosis was cercinoma of the descending colon. At surgery there was no evidence of metastasis and she was treated with resection of distal transverse colon, and proximal sigmoid colon. No recurrence has been odserved during 12 years after surgery.
Case 2. A 19-year-old female with a complaint of diarrhea. Preoperative diagnosis was carcinoma of the transverse colon. Liver metastasis and extensive mesentrial lymph node involvement were found on exploration of the abdomen. She received right hemico-lectomy but died of the disease 26 months after surgery. Histologically, both cases were well differentiated adenocarcinoma.

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