s is the curious custom of medical science, A valuable contributions may lay dormant for decades or centuries without proper acknowledgment or appIication. Spivak [8], in a historical note, cited TaveI who in 1906 advocated the use of a hollow viscus as a tube between the stomach and skin. In 1950 Levy [6], unaware of the earIier applications, performed two jejunogastrostomies for feeding in the presence of obstructing tumors of the esophagus. A more recent case of such a jejunogastrostomy for feeding is presented herein. The reader is referred to Cunha’s [4] comprehensive treatise on the inception and evolution of gastrostomy between 1837 and 191 I. PerusaI of the Iiterature in the past forty-five years sheds Iittle additiona knowIedge on gastrostomy, aIthough we11 over fifty different technics or plans of operation have been published [4,7,8]. RecentIy a prosthesis of stainless steel or nylon has been used by Barnes and Redo [I] for gastrostomy purposes. Indications for performing gastrostomies have been reduced in the past decade due to the thoracic approach toward more radica1 extirpation of tumors. AIso, there has been a decrease in the incidence of Iye strictures of the esophagus in this country. NevertheIess, the occasion stiI1 arises when an obstruction of the gastrointestina1 tract above the cardia may require a temporary or permanent gastrostomy. InoperabIe carcinoma of the esophagus, as an indication, exceeds the combined total of a11 others. ShackeIford [7] suggests the criteria for a satisfactory gastrostomy: It must (I) be continent and not leak gastric juice or ingested foods; (2) permit the easy insertion of a tube so that the patient can feed himself; (3) present no unheaIed granuIation surface subject to infection; and (4) in certain cases permit easy and repeated instrumentation such as retrograde bougienage, retrograde esophagoscopy and gastroscopy. In general, temporary gastrostomies should be Iined with serosa because the fistula will close spontaneously when the tube is removed. A fistula intended for proIonged or permanent use shouId have its tract Iined with mucosa. Furthermore, since peristalsis tends to eject gastric contents, the Ionger and more indirect the cana is between the stomach and abdominal wall, the greater is the contro1 over regurgitation. Stoma1 complications such as leakage or excessive granulations ranged from 5.6 to 14.2 per cent for the serosal types [2,~,9] and 12.5 to 25.0 per cent for the mucosa1 types [3,5]. However, the statistica vaIidity of these figures is to be questioned because of the sizes of the series, seIection of cases and the surgical era. The disadvantages of “serosa1” gastrostomies are: (I) the catheter must remain consistently in the stomach or the fistula wiI1 cIose; (2) the catheter may sIip out or be puIIed out and may be difficult to repIace. Some unusua1 compIications have been encountered such as pyIoric obstruction by the gastrostomy tube, erosion.of the tube through the stomach and diaphragm, and compIete prolapse of the stomach through the gastrostomy [2]. The chief disadvantage of “mu&al” gastrostomies is that they are more difficult to perform. The operative procedure is necessarily proIonged on a poor risk patrent. However, with modern technics of surgery and anesthesia, the time factor has become Iess cogent.