Recurrent common bile duct stones as a late complication of endoscopic sphincterotomy.

Background: Endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy (ES) has become well established as a modality for the management of common bile duct stones (CBDS), especially in the setting of associated cholangitis. Our study aims to determine the rate of long term morbidity of recurrent CBDS post ES.

Methods: A retrospective analysis of patients who underwent ERCP and ES (ERCP+ES) was undertaken on a prospectively maintained database from 1998 to 2012 at the Northern Hospital, Melbourne.

Trans-cervical resection of a separate substernal goitre.

Introduction: A separate substernal goitre which is not continuous with the main cervical thyroid proves a unique challenge for resection. A trans-cervical approach is preferred but may be hazardous due to the possibility of ectopic thyroid tissue with alternate blood supply.

Presentation Of Case: A 72year old female who had a previous left hemithyroidectomy presents with a symptomatic central substernal thyroid mass.

Primary adenocarcinoma arising at an ileostomy site: an unusual cause of bowel obstruction.

Adenocarcinoma of the ileostomy stoma is a rare complication of ileostomy. An instance of adenocarcinoma of the ileostomy stoma, which presented as a small bowel obstruction, is reported in a 58 year old woman who had nearly a 30-year history of abdominal problems that had been treated conservatively.

Surgical significance of the bile duct of Luschka.

In 20 post-mortem dissections, the subvesical bile duct of Luschka was noted in six specimens. Microscopic examination of ten other post-mortem gallbladders revealed small bile ducts on the gallbladder surface in five. Four cases of injury to the duct of Luschka during cholecystectomy are described and illustrated with cholangiographic and histological evidence.