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Herman L. Allen, MD
Youngstown, Ohio

JAMA. 1970;213(1):129.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor:—

In reference to "Halothane and Liver Failure" (211: 2145, 1970) I would like to agree with the author that halothane in rare instances, like other drugs, may cause hepatitis and even acute liver necrosis. Having agreed with the authors on this point, our paths divide.

The clue to this patient's problem is a syndrome which appears to be a first and probably should be called the "St. Louis syndrome." That is the occurrence on the second postoperative day, after elective cholecystectomy, of wound dehiscence and colon perforation. I do not think this has been recorded before.

The clinical information presented is inadequate, but a logical explanation for the "St. Louis syndrome" might be as follows: unrecognized perforation of the colon at surgery, consequent peritonitis, sepsis, diaphragmatic irritation, coughing, and then a rare second-day dehiscence. This patient must have had sepsis, some cardiac decompensation plus the admitted periods . . . [Full Text PDF of this Article]

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