Secondary sclerosing cholangitis following extracorporeal membrane oxygenation for acute respiratory distress in polytrauma.

Secondary sclerosing cholangitis is a recently identified phenomenon affecting the biliary tree. A subtype has been described in critically ill patients (SSC-CIP). However, underlying mechanisms are unknown, and few cases have been reported following extracorporeal membrane oxygenation (ECMO).

Ascites matters.

The excess accumulation of intra-peritoneal fluid, referred to as ascites, is an important clue that points to a significant underlying illness. This may be due to a pathological event within the peritoneal cavity or secondary to an underlying systemic condition. Ascites is broadly classified into transudate and exudate, based on protein content, with a potential wide range of differential diagnoses.

Gallbladder volvulus: it's a small whirl.

An 85-year-old female with an extensive past medical history attended our accident and emergency department with vague abdominal pain and distension. Clinical examination and initial blood tests demonstrated features of sepsis and she was commenced on broad spectrum antibiotics. Following admission, a contrast-enhanced CT scan of the abdomen and pelvis was performed, which showed an unusual configuration of the gallbladder.

Out of sight but kept in mind: complications and imitations of dropped gallstones.

Objective: The purpose of this article is to describe the diagnostic pitfalls caused by dropped gallstones left in situ after laparoscopic cholecystectomy.

Conclusion: Dropped gallstones may rarely become symptomatic, causing recurrent abscesses. Diagnosis is challenging due to unusual clinical presentations, myriad locations, and radiologically occult calculi.