Impacted Common Bile Duct Stone Managed by Hepaticoduodenostomy.

A bypass procedure such as a hepaticoduodenostomy may be an alternative to the traditional choledochoduodenostomy in the management of the retained, impacted distal common bile duct (CBD) stone, especially in the presence of sepsis. We present herein a hepaticoduodenotomy performed for a retained, impacted distal CBD stone in a low-resource setting with a good outcome. This impacted stone had complicated an open cholecystectomy for acute cholecystitis by causing the dehiscence of the cystic duct stump as a result of distal biliary obstruction.

Impacted common bile duct stone managed by hepaticoduodenostomy.

A bypass procedure such as a hepaticoduodenostomy may be an alternative to the traditional choledochoduodenostomy in the management of the retained, impacted distal common bile duct stone especially in the presence of sepsis. In low-resource settings with lack of fluoroscopy, fibreoptic instruments (choledoscope) or radiologically guided wire baskets or balloons for stone retrieval, there are operative hazards in blindly exploring the common bile duct. We present herein a hepaticoduodenostomy performed for a retained, impacted distal common bile duct stone in a low-resource setting with a good outcome.

A rare presentation of a splenic abscess.

Although the spleen is frequently enlarged in association with systemic infection, splenic abscesses are rare. They result from direct or hematogenous spread, or when a hematoma becomes infected. We present a case of the rare splenic abscess in a low-resource setting.

A case of obstructive jaundice without biliary stones in a low resource setting.

Although not common, Mirizzi's syndrome (type 1) is a differential diagnosis in a patient with cholecystitis and obstructive jaundice, after a thorough clinical assessment. The jaundice would be resolved by cholecystectomy.