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Total anomalous pulmonary venous drainage is uncommon and probably accounts for about 2 per cent of all congenital cardiac malformations (Keith et al., 1958). It may be found as an isolated anomaly or in association with gross malformations of the heart. These are usually referred to as the isolated form and the' complicated form respectively, and the former is the more common variety. Further subdivision into different types is made on the basis of the site of drainage of the anomalous pulmonary veins. This is of practical importance because it leads to wide differences in the clinical picture, each with its own particular diagnostic, prognostic, and therapeutic problems. The subject has been well reviewed by Gott et al. (1956), Darling et al. (1957), and Keith et al. (1958). The case to be described, one of pulmonary venous drainage via the left gastric vein, represents an exceedingly rare type of the isolated form. Indeed, we have been unable to trace any previous report of this type of drainage except for a briefreference to it in the complicated form (Keith et al., 1958). A remarkable feature of the case is the occurrence of a fatal hmmatemesis from cesophageal varices at the age of three days. This in itself must be almost unique, though the nature of the malformation provides an apt explanation for it.

TOTAL ANOMALOUS DRAINAGE OF PULMONARY VEINS INTO THE LEFT GASTRIC VEIN