In this report, we described two male patients with Hughes-Stovin syndrome. The first patient was a 26-year-old male who initially presented with deep vein thrombosis (DVT) in the right lower limb followed shortly by hemoptysis. Pulmonary CT angiography revealed bilateral pulmonary artery aneurysms secondary to underlying pulmonary vasculitis. While the second case was a 16-year-old male patient who initially presented with generalized fits due to sagittal sinus thrombosis and later followed by DVT in the left lower limb. Pulmonary CT angiography showed small pulmonary artery aneurysms with thrombosis of peripheral pulmonary artery branches. Both patients were treated successfully with steroids and immunosuppressive therapy and showed clinical improvement.

Background and Aim: latrogenic biliary injuries are among the most serious complications of biliary surgery. Reparative surgery is challenging, especially in recurrent patients. The aim of this study was to evaluate the success of high hepaticojejunostomy in the management of various types of iatrogenic injuries, both as primary repair and after previous failed attempts at surgical repair. Patients and Methods: Twenty-two patients (13 females, 9 males) with a mean age of 44.7 years were included and injury had occurred during: open cholecystectomy in 19 patients; laparoscopic cholecystectomy in 2 patients, and repair of an incisional hernia in 1 patient. Eight patients had had previous repair attempts with bilioenteric anastomosis in 6 and primary repair over a T tube in 2 patients. The last previous surgery was 1 week to 6 years earlier. The level of injury was diagnosed by endoscopic retrograde cholangiopancreaticography in 15 patients, and by percutaneous transhepatic cholangiography in 7 patients. The patients underwent Roux-en-Y hepaticojejunostomy at the confluence in 15 (68%) and just below the confluence in 7 (32%). The mean follow-up period was 25 ± 15 months. Results: Eighteen patients (82%) had an uneventful recovery and good outcome during follow-up, whereas 4 patients (18%) had moderate or poor outcome. There was no correlation between the duration of biliary injury or previous repair attempts and the outcome of surgery. Conclusion: High hepaticojejunostomy offers good results in the management of complicated iatrogenic biliary injuries. Failed previous attempts at repair do not alter the success of reparative surgery.