Type Va Duplication of the Common Bile Duct With Type IIIa Intrahepatic Bile Duct Anatomy: A Rare Combination of Dual Biliary Ductal Anomaly With Difficulty to Extract Common Bile Duct Stone.

Extrahepatic duplication of the common bile duct (CBD) is an extremely rare anatomic variation seen in the biliary tract. It represents failure of regression of the primitive duplicated biliary ductal system, resulting in five different subtypes of the duplicated CBD as described by Choi To date, only few such cases have been reported in the literature. Associated variation in branching of intrahepatic bile ducts presenting as combined dual ductal anomaly is even rarer phenomena to be seen.

An Expert Review and Recommendations on the Rational Use of Proton Pump Inhibitors: Indian Perspective.

Background: Proton pump inhibitors (PPIs) are the mainstay of treatment for acid peptic diseases (APDs), but are often irrationally prescribed in clinical practice. Appropriate prescription of PPIs is needed to optimize outcomes, and minimize risks and cost burden on the healthcare system.

Objective: To review available literature on efficacy and safety of proton pump inhibitors (PPIs) and give recommendations for rational use of PPIs from an Indian perspective.

Sofosbuvir and Ribavirin for 24 Weeks Is An Effective Treatment Option for Recurrent Hepatitis C Infection After Living Donor Liver Transplantation.

Background: Recurrent hepatitis C virus (HCV) has been a serious problem after liver transplantation (LT). We report our experience of 24-week therapy with sofosbuvir (SOF) and ribavirin (RBV) in post-LT recurrent HCV in living donor liver transplantation (LDLT) setting in South Asia.

Methods: Data from all patients treated for post-transplantation HCV recurrence in a single center were analyzed.

Endotherapy for pain in chronic pancreatitis.

Pain is the most distressing symptom of chronic pancreatitis. Although the pathogenesis of pain is still poorly understood, an increase in intraductal pressure may be the dominant factor. The management of pain can involve medical, endoscopic, neurolytic, and surgical therapies.

Role of branched-chain amino acids in liver disease: the evidence for and against.

Purpose Of Review: There is ample evidence that patients with liver disease have an ongoing energy and protein catabolism. Nutritional management in these patients must receive high priority. The administration of branched-chain amino acids to patients with liver disease has been a controversial subject.

Management of patients with HBeAg-negative chronic hepatitis B.

Chronic hepatitis B (CHB) is one of the leading causes of morbidity and mortality worldwide. Although various drugs are available for the treatment of CHB, emergence of the hepatitis B e antigen (HBeAg)-negative mutant variant, specifically in Asia, the Middle East and southern Europe, is creating a new challenge as this variant is less responsive to available treatments. HBeAg-negative CHB rapidly progresses to cirrhosis and its related complications.

Epiploic appendagitis: Report of two cases.

Epiploic appendagitis (EA) refers to primary or secondary inflammatory disease of the epiploic appendages: peritoneal pouches of subserosal fat, which run in parallel rows beside the taenia coli of the colon. It is an uncommon but self-limiting condition, which often mimics acute appendicitis or diverticulitis. An accurate diagnosis of EA can be made by performing an abdominal computed tomography scan.

Gastric tuberculosis presenting as linitis plastica: a case report and review of the literature.

Gastric tuberculosis is rare and usually presents as an ulcerated lesion or gastric outlet obstruction. Rarer presentations include massive gastrointestinal bleed and gastric perforation. A case of gastric tuberculosis presenting as linitis plastica is reported here.

Association of extent and infection of pancreatic necrosis with organ failure and death in acute necrotizing pancreatitis.

Background & Aims: Organ failure is the usual cause of death in acute necrotizing pancreatitis. Our objective was to study whether the extent and infection of pancreatic necrosis correlate with organ failure and mortality.

Methods: All consecutive patients with acute pancreatitis were prospectively studied.

Good's syndrome: an unusual cause of chronic diarrhea.

A 50-year-old man presented with recurrent episodes of pulmonary infections over a period of 5 years, chronic small bowel diarrhea and weight loss of 6 months' duration. On evaluation he was found to have a thymoma, intestinal infection with giardia, oral candidiasis, and low immunoglobin levels. He was diagnosed to have Good's syndrome.

Infectious mononucleosis presenting as acute hepatitis, with marked leukocytosis and renal involvement.

We report a 45-year-old lady with infectious mononucleosis due to Epstein-Barr virus. The unusual features of this case included a negative heterophil antibody test, marked leukocytosis, renal involvement and jaundice.

Propofol--a safe and effective sedative for endoscopy.

Background: Propofol has recently been reported to be a safe sedative for endoscopy.

Methods: One hundred consecutive patients more than 18 years of age undergoing an endoscopic procedure were included in the study. The risk of sedation was calculated using the American Society of Anesthesiology risk class.

Enteral nutrition delivery technique.

Purpose Of Review: Ingestion and absorption of a nutritionally adequate diet is necessary to maintain normal body composition and organ function. Patients with all kinds of diseases are at increased risk of developing nutritional abnormalities from anorexia, dietary restriction, malabsorption, increased intestinal losses or altered nutrient requirements. Therefore, it is important for doctors to understand the general principles of clinical nutrition for optimal management of patients with various disorders.

Incidence, etiology, and impact of Fever in patients with acute pancreatitis.

Background/aim: Fever, as a significant event, has not been studied systematically in patients with acute pancreatitis. We studied prospectively incidence, etiology, and impact of fever on the management and outcome in patients with acute pancreatitis.

Methods: All consecutive patients with acute pancreatitis were studied for the development of fever, its etiology, and its influence on the management and outcome of acute pancreatitis.