Due to the ever increasing popularity of laparoscopic cholecystectomy (LC), many radiologists and gastroenterologists have noticed an epidemic of bile duct injuries due to subsequent complications. We report on five cases of post-LC minor bile duct injuries and document our preliminary experience in their management. Although the majority of minor bile leaks resolve spontaneously, particularly if a surgical drain has been left in situ, percutaneous drainage (PD) can be used alone or in addition to endoscopic management to treat symptomatic bile leaks and biloma formation. Bile leaks without associated abdominal collections should be first identified by endoscopic cholangiography followed by sphincterotomy and/or stenting. Surgery should only be reserved for cases of major bile duct injury if PD and endoscopic management have failed initially.

Twenty-five percent of the world's population could be suffering parasitic infestation. Highest prevalence is in underdeveloped agricultural and rural areas in the tropical and subtropical regions. In some areas incidence may reach 90% of the population. In contrast, some major economic projects intended to promote local development have, paradoxically, caused parasitic proliferation, e.g. bilharziasis in Egypt and Sudan and Chagas disease in Brazil. The commonest cosmopolitan gastrointestinal parasite is Entamoeba histolytica. Some intestinal parasite are endemic in temperate climates, e.g. Entrobius vermicularis. The AIDS epidemic has increased the prevalence and severity of parasitic disease, particularly Strongyloides stercolaris. Tropical parasites are seen in Western people who travel to tropical countries. Radiology has acquired a major role in diagnosis and management of gastrointestinal parasite infestations and their complications.

of investigations, e.g., sonography, cholecystogram, lipid profile, endoscopic retrograde cholangiopancreatography (ERCP) outcome, surgical treatment, and complications. An attempt to define the etiology was made. ResultsTwenty-three cases of acute pancreatitis (0.03070) were admitted over this 40 month period. These were composed of 16 females (age range 12-79 ye~rs, mean 51.8 years) and 7 males (age range 7-59 years, mean 42.3 years). In all cases, the presentation was acute with abdominal pain, nausea, and vomiting. In all instances the serum amylase was over 600 lUlL (normal range = 0-100 lUlL). In 21 out of 23 cases, the level was greater than 1,000 lUlL. The diagnostic tests and etiology are shown in Tables 1 and 2, respectively.The presence of gallstones was confirmed in nine patients, in one of which the pancreatitis occurred two days post-cholecystechtomy, and cholelithiasis was believed to be the causative factor. In three patients, hyperlipidemia was considered to be the predisposing factor. These three patients were known to have hyperHpidemia before their presentation with acute pancreatitis. A seven ye.ar old child presented with acute pancreatitis due to a mumps infection and one patient had a hydatid cyst obstructing the lower The exact cause of acute pancreatitis is uncertain in some patients. However, there are certain well documented predisposing causes such as alcoholism, 1 hyperlipidemia,2 hypercalcemia. J biliary tract disease ... • trauma,6 and familial inheritance.7 Within the Kingdom of Saudi Arabia, alcohol consumption is prohibited. We report a retrospective study of patients with acute pancreatitis who were admit1ed to the Riyadh Armed Forces Hospital over a 40 month period to show the relatively low incidence of alcoholism as an etjologic factor.

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