The authors report a case of a common bile duct cyst in a 19-year-old patient referred for the management of chronic pain in the right hypochondrium, without other associated symptoms. The abdominal computed tomography scan revealed a bile duct cyst confirmed by abdominal magnetic resonance imaging (MRI) (type 1c according to Todani). Laparotomy had revealed a common bile duct cyst. The procedures consisted of a resection of the main bile duct and cholecystectomy + hepatico-jejunal anastomosis (Roux-en-Y method). The anatomopathological examination had shown a fibrous-walled bile duct cyst with epithelial hyperplasia and dysplasia without signs of malignancy. The post-operative follow-up was simple and the return home had taken place on the 7 th postoperative day. The patient had been seen for routine check-up 51 days after surgery. She was in apparent good health without particular complaints.

Hashimoto’s encephalopathy (HE) is a rare and poorly understood neuropsychiatric illness of presumed autoimmune origin, with elevated titres of anti-thyroid antibodies. Its clinical presentation is highly variable that mimic a variety of neurologic and/or psychiatric disorders. Clinical presentation often suggests an infectious etiology which often leads to a mistaken diagnosis. We present the case of 35 year-old female who presented with acute onset behavioural disturbance of one day duration. On examination she was unkempt, emotionally labile, appeared withdrawn and unable to respond to questions. She had no focal neurological deficits. CNS infection was suspected and lumbar puncture was suggested, which the family members refused.She was empirically treated with intravenous acyclovir and ceftriaxone.Metabolic disorder, infectious and toxic issues were ruled out through laboratory testing.In view of her previous history of hyperthyroidism, suspicion of Hashimoto encephalopathy arose.The diagnosis was supported by the elevated level of anti-thyroglobulin (TG) antibody.We report this case to increase its awareness as it is one of the few treatable and easily reversible causes of acute encephalopathy. It should be considered in the differential diagnoses in any patient who presents with acute behavioural disturbance and has concurrent thyroid disorder.International Journal of Human and Health Sciences Vol. 04 No. 04 October’20 Page : 309-312