for fruitful discussions

Three different descriptions have been applied to vascular lesions of the gastrointestinal tract in Turner's syndrome-namely haemangioma, telangiectasis, and venous ectasia.4 However, reviewing the way these lesions are described by various authors, the terminology seems to overlap greatly, and it may well be that there is one under-lying abnormality-namely ectasia of capillaries, venules, and veins. Depending on the preponderance of these three findings, this abnormality may present as a variety of macroscopic appearances. Diagnosis of this abnormality without resort to laparotomy may be difficult. Telangectasis has been reported as visible via the sigmoidoscope5 but this is unlikely to be helpful in patients such as ours with macroscopically visible ectasia only in the distribu-tion of the superior mesenteric vessels. Laparoscopy or culdoscopy would seem to be the most helpful investigation.3 Most patients so far reported have each had their first haemorrhage before 20 years of age. In the 20 cases reported by Passarge6 most bleeds were self-limiting but 3 were life-threatening and 2 patients, notably both young children, died. In paediatric practice, a cause for recurrent gastrointestinal blood loss can often be found without resort to surgery. However, explorative laparotomy is occasionally required. Awareness of the condition discussed here may help prevent unnecessary laparotomy in children with known or suspected Turner's syndrome. Having established the diagnosis, subsequent haemorrhages, which are likely to occur, can generally be managed conservatively