Enterolithiasis is an uncommon entity in humans but frequently seen in equine mammals. A primary enterolith is a mineral concretion formed within the gastrointestinal tract due to the alteration in the anatomical integrity due to variety of conditions resulting in intestinal stasis. We report a patient with small intestinal obstruction due to a primary enterolith. A 65-year-old woman presented to the emergency department with central colicky abdominal pain, absolute constipation followed by vomiting. An enterolith located in distal ileum causing small intestinal obstruction was established with the aid of abdominal X-ray radiograph and computed tomography. Exploratory laparotomy was performed to extract the enterolith and to resect a strictured proximal jejunal segment which was suspected to be the original site of enterolith formation. Chemical analysis of the enterolith supports the speculation of a proximally formed primary enterolith eventually migrating to the site of impaction in the terminal ileum.

The main risk of paraquat poisoning is from deliberate ingestion. Serious accidental or occupational poisoning is comparatively rare. We report two patients who had accidental exposure to paraquat, resulting in scrotal burns in both and systemic poisoning in one, while attending to a patient who had ingested paraquat for deliberate self harm.

Results: Literature review included twenty-one publications, excluding five articles that did not mention reoperation for remnant gallbladder. Repeated articles describing the same case were excluded, the one containing the most complete information was analysed. We found 38 cases of "recholecystectomy" in the literature. Most of them (30 cases) were reoperated laparoscopically. The interval between first and second surgery ranged from 2 weeks to 32 years. Indications for reoperation were more frequently right upper quadrant pain. Conclusion: Literature with reference to subtotal cholecystectomy and reformed gallbladder is scarce. This surgery became an important technique used mainly for cases of severe cholecystitis. Caution is necessary since diagnosis for reformed gallbladder is unusual and the reoperation increases morbidity rates.

Key learning points Ÿ Approximately 10 percent of patients with gall stones will have common bile duct stones Ÿ Laparoscopic cholecystectomy and common bile duct exploration (LCBDE) is a single stage option for surgical treatment of gall stones in the common bile duct Ÿ The reported incidence of post-procedure acute pancreatitis is less for LCBDE compared with endoscopic retrograde cholangio-pacreatography

symptoms. Diagnosis of CD was confirmed by histology. Cholangiocarcinoma was present in one patient (2,6%). Conclusion: IHBC in Argentina are more common in females with left hemiliver involvement. Surgical resection is the best curative option in unilateral disease with long term survival free of symptoms and complications. In cases of bilateral disease types 5 or 4A cysts, hepaticojejunostomy could be an altermative treatment before indication of liver transplantation.