The most common cause of biliary obstruction is choledocholithiasis. Endoscopic sphincterotomy is the preferred therapy for retained common bile duct stones. However, stones may pass spontaneously or get impacted at the ampulla [1]. Recent data suggest that precut sphincterotomy is a safe and effective technique that facilitates impacted stone extraction [2]. A 60-year-old man was admitted due ...

A chronic anal fissure is a common perianal condition. This review aims to evaluate both existing and new therapies in the treatment of chronic fissures. Pharmacological therapies such as glyceryl trinitrate (GTN), Diltiazem ointment and Botulinum toxin provide a relatively non-invasive option, but with higher recurrence rates. Lateral sphincterotomy remains the gold standard for treatment. Ana...

The majority of common bile duct stones can be effectively treated by endoscopic sphincterotomy and stone extraction using basket or balloon extractor. Stones more than 2 cm in diameter on the other hand require mechanical, electrohyraulic lithotripsy and sphincterotomy and balloon dilation. Mechanical lithotripsy may not be successful because of the size, consistency and site of the stones. In...

A 65-year-old female presenting with hepatobiliary cystadenoma (HC) comprised of multiple cysts in the liver and a non-specific epigastric pain is reported herein.  Ultrasound study demonstrated dilated common bile duct (CBD) and intrahepatic bile ducts, plus two spherical stone-like bodies filling defects in the proximal CBD. Sphincterotomy and basket performed for the patient were not success...

chronic anal fissure is the most common cause of anal pain associated with internal anal sphincter hypertonia. reduction of hypertonocity is a special treatment for fissure healing. for this purpose chronic anal fissures were conventionally treated by anal dilatation or by lateral sphincterotomy. however, both of these methods may cause a degree of incontinence in some patients. the uptake of m...

to determine whether the medical treatment of anal fissure can be an effective alternative for surgery methods: retrospectively, we randomly selected 190 patients being treated for anal fissure between the years 2005-2010 in 3 equal groups: group a: patients who received medical treatment with topical nitroglycerin, group b: patient treated with topical diltiazem, and group c: patients underwen...

Background: Blunt injuries to the gallbladder occur rarely, and the incidence of isolated damage to the gallbladder is even smaller. We report a case of delayed presentation of isolated rupture of the gallbladder following blunt trauma to the abdomen. Case presentation: A 65 year old lady presented through the Emergency Department with a 1 week history of blunt trauma to her abdomen. She compla...

Clearance of a difficult biliary stone can be obtained using various interventional techniques such as endoscopic sphincterotomy followed by papillary large balloon dilation, mechanical lithotripsy, peroral cholangioscopy-assisted intraductal electrohydraulic/laser temporary plastic stent insertion, percutaneous transhepatic cholangioscopy-guided and extracorporeal shock wave lithotripsy. We he...

INTRODUCTION Only limited data are available regarding the safety of therapeutic ERCP in pregnancy. We report our experience with therapeutic ERCP in pregnant women. METHODS Medical records of 18 pregnant women (first trimester 4, second 6, third 8) who underwent ERCP between July 1994 and December 2004 were reviewed. Patients and their families were contacted to assess the well being of moth...

It is well known both by clinical examination and by objective measurement that a high pressure zone is to be found in the anal canal, due to the action of the anal sphincteric muscles. Division of part of the internal anal sphincter in the operation of internal sphincterotomy resulted in a diminution in this pressure zone (Bennett and Duthie, 1964). The pressure remaining after internal sphinc...