A 69-year-old cholecystectomized female with known total situs viscerum inversus presented recurrent colicky pain in the left upper abdominal quadrant and jaundice. Laboratory parameters showed increased neutrophils and coniugated bilirubin of 5.53 mg/dl. US and MRCP confirmed total situs viscerum inversus and a dilatation of the intra- and extrahepatic ducts with a peripapillary 13 mm stone. E...

The present case reports a 78-year-old male with a history of total gastrectomy with Roux-en-Y anastomosis and splenectomy for gastric cancer in 2007 and cholecystectomy in 2014 for cholelithiasis. The patient presented with a 1-week history of abdominal pain, fever, and vomiting. Laboratory tests revealed leukocytosis (17,290 × 10 3 /μL [normal range: 3.8–10.6]) and elevated total bilirubin (3...

AIM: to improve the results of chronic anal fissure treatment.PATIENTS AND METHODS: prospective randomized study included 176 patients divided in two groups. Eighty-eight underwent excision combination with injection botulinum toxin type A (incobotulinum toxin) into internal sphincter (main group, BTA), and 88 lateral subcutaneous sphincterotomy (control LIS).RESULTS: on 30th day after surgery,...

An anal fissure is a longitudinal ulcerated area in the vertical axis of squamous lining canal between verge and dentate line, noted 10–15% proctological patients. Present study was aimed to study, acute fissure-in-ano relation clinical diagnosis management at tertiary hospital. hospital based prospective observational conducted patients 18-70 years age ( including males & females ), w...

Choledochocele is a cystic dilatation of the intraduodenal portion of the common bile duct that can protrude into the duodenum. Although often classified as type III biliary cyst, choledochocele has distinctive demographic and anatomic features, and is associated with a lower risk of malignancy as compared to other types of choledochal cysts. Patients with this condition present with biliary co...

Ascariasis is one of the most common helminthic diseases. Its most feared complication is migration into the biliary tree. Some authors recommend immediate duodenoscopy in all cases of biliary migration, with sphincterotomy for the extraction of the parasites, and surgical extraction in case of intrahepatic ascariasis. We followed prospectively 69 patients with ultrasonographical evidence of mi...

Background and aims: The role of sphincter of Oddi dysfunction (SOD) and sphincter of Oddi manometry (SOM) in patients with post-cholecystectomy pain and idiopathic recurrent acute pancreatitis (IRAP) is controversial. We sought to survey the American Gastroenterology community to define current approaches. Methods: An electronic survey was sent to U.S. members of the American Society of Gastro...

Sphincter of Oddi dysfunction (SOD) is a syndrome of chronic biliary pain or recurrent pancreatitis due to functional obstruction of pancreaticobiliary flow at the level of the sphincter of Oddi. The Milwaukee classification stratifies patients according to their clinical picture based on elevated liver enzymes, dilated common bile duct and presence of abdominal pain. Type I patients have pain ...