No abstract

Pseudocysts are a recognised complication following acute or chronic pancreatitis. Usually located in peripancreatic areas, they have also been reported to occur in atypical regions like liver, pelvis, spleen, and mediastinum. Mediastinal pseudocysts are a rare entity and present with myriad of symptoms due to their unique location. They are a clinical challenge to diagnose and manage. In this paper, we describe the clinical and radiological characteristics of mediastinal pseudocysts in 7 of our patients, as well as our experience in managing these patients along with their clinical outcome.

Pancreatojejunostomy method was performed by two procedure (complete laparoscopically or mini-laparotomy). Results: Most common diseases included NET, papilla of Vater carcinoma (T1 or T2) and IPMN. The laparoscopic group (LG) was 18 patients. The mini-laparotomy group (MG) was 7 patients. The patient's back ground of two groups were similar (age, BMI and diameter of the pancreatic duct). The median procedure time of LG (76 min) was significantly longer than that of MG (46 min). Complication rates and POPF rates were similar with each groups. The median hospital stay of LG (13 days) was shorter than that of MG (32), but not significantly. Conclusions: Postoperative outcomes after laparoscopic pancreatoduodenectomy are unaffected by two different pancreatojejunostomy methods. The degree of difficulty of pancreatojejunostomy with mini-laparotomy depends on the shape of the body. The accumulation of further similar studies will be needed.

Extrahepatic bile duct obstruction can be caused by various pathologies, most of them being malignant. Painless, progressive jaundice is the usual mode of presentation. We report a case of distal Common Bile Duct (CBD) obstruction due to a Benign Intramural Beale gland hyperplasia mimicking a periampullary carcinoma. Peribiliary glands (Beale Glands) are a group of seromucinous glands, normally seen within the fibromuscular wall and periductal connective tissue in the extrahepatic and large intrahepatic ducts and also in the neck of the Gall bladder. These glands drain into the bile duct lumen through small channels referred to as sacculi of Beale. Intramural Beale ducts are lobular aggregates of mucous glands that lie within the wall of the bile duct. Beale Gland hyperplasia is uncommon, and is rarely large enough to be visible macroscopically or with imaging as an incidental finding. There are no case reports of this rare entity. It is distinguished from well differentiated bile duct adenocarcinoma by the preservation of the lobular architecture, lack of cytological atypia and lack of perineural invasion. This case is reported for its rarity.

ileum without underlying adenoma, inflammatory disease, or duplication. As far as pathogenesis is concerned, we cannot exclude any of the four basic mechanisms proposed above. Clinical presentation of SCC of the ileum is similar to that of other ileal tumors. Optimal treatment and the prognosis are illusive because of the rarity of this condition. Surgery is the corner stone in the management ofthe disease. 10 Due to the small number of cases available in the literature the effects of chemotherapy and radiotherapy on the survival and recurrenceare unknown.