Introduction: Though human beings look similar in their general anatomical appearances but during the investigation of a particular structure in detail, it is surprising how frequently we meet one sort or another type of variation. Literature reports that accurate dimensions of CBD are debatable. Therefore, determination of a spontaneous abnormality or atypical variation is important and reference range plays a significant role to classify the normal or abnormal duct. Materials and Methods: A total of thirty (30) cadavers were dissected at MGM Medical College Mumbai, India from Jan 2012 to March 2013 for anatomical features of the common bile duct-like their size, variations in the course and termination. Results: The length of the common bile duct varies 35.19 mm to 62.43 mm with Mean ± SD 46.92 ± 7.91 mm and diameter varied between 3.65 mm to 10.31 mm with mean value 6.50 ± 1.77. The correlation between length and diameter of common bile duct is statistically insignificant (p = 0.243) Conclusion: We established a reference range for the CBD length and diameter. Thus, the exact knowledge of the anatomy of the common bile duct is significant for successful hepato-biliary surgery and biliary pathology.

Scrub typhus is common in rural Nepal's southern plains, but its diagnosis remains difficult due to a lack of clinical suspicion and poor diagnostic resources. The absence of common manifestations of the condition including eschar might further complicate this problem and may result in treatment delays. We report a case of scrub typhus with the primary presentation of reactive monoarthritis of the left hip joint in a 19-year-old male who presented with difficulty in walking, and pain over the left hip joint. Ultrasonography of the left hip and thigh showed features of synovitis and iliopsoas bursitis. After a meticulous workup, a diagnosis of human leukocyte antigen B27 negative reactive monoarthritis of the left hip joint triggered by scrub typhus infection was made and the patient was treated with doxycycline. Delays in treatment and the rate of complications can be prevented with high clinical suspicion and awareness of the atypical presentation of the condition.

Kawasaki disease (KD) is an acute rheumatological illness usually affecting children between six months and five years of age. It is a vasculitis syndrome of medium-sized vessels that has typical clinical characteristics such as fever, rash, cervical lymphadenopathy, conjunctivitis, and mucosal changes. However, sometimes, it may present with the features of shock when it is known as Kawasaki disease shock syndrome (KDSS). The actual etiology of this disease is still unknown. The primary treatment of this disease is aspirin and intravenous immunoglobulin (IVIG). The most common and serious complication of KD is cardiac complications which can be avoided by IVIG if given on time. KDSS is the other rare but serious early complication that can be presented to the ED as an initial presenting feature. Early diagnosis of KDSS in the ED and its treatment is very important to prevent early and late complications, including cardiac complications of this disease. Although the usual age group for this disease is under five years, here we have presented a rare case of KDSS in a nine-year-old female child.

Acquired elastotic hemangioma is a hemangioma variant which was first described in 2002. Usually it is characterized by being a benign, solitary, slow growing lesion and associated with solar exposure but here we discuss a case of 50 years old male from Australia, who had multiple pigmented and violaceous lesions on the back which he had noticed for 5 years. The cases of multiple lesions are reported few in the literature. The lesions had characteristic clinical dermatoscopic feature showing typical violaceous lesions with widespread shiny white structure without any vessels. Histopathology revealed band like proliferation of blood vessels involving superficial dermis arranged horizontally parallel to the epidermisalong with elastosis in dermis. Treatment was done through surgical excision with no relapse reported.