These results suggest that endoscopic endoprosthesis for large or difficult CBD stones is an effective method to clear the duct in selected cases, as well as an important definitive treatment in high-risk patients.

Two recent studies described a temporal association between a high-amplitude and high-frequency myoelectrical activity of the anal sphincter and the occurrence of proctalgia, which suggest that paroxysmal hyperkinesis of the anus may cause proctalgia fugax. We describe a single case of proctalgia fugax responding to anal sphincter injection of Clostridium botulinum type A toxin. The presumed aetiology of proctalgia fugax is discussed and the possible mechanism of action of botulinum toxin (BTX) in this condition is outlined. Botulinum A toxin seems to be a promising treatment for patients with proctalgia fugax, and further trials appear to be worthwhile for this condition, which has been described as incurable.

A new case of splenic-gonadal fusion in an 8-year-old boy is reported in which the sonographic findings were highly suggestive to include the condition in the differential diagnosis. A separate mass with medium-level echoes and a homogeneous echo texture, surrounded by a clearly visible echogenic capsule, was found in contact with the lower pole of the left testis. The particular character of this congenital anomaly is emphasized and the pathogenesis, diagnosis, and treatment are discussed.

We report a new case of a brucellar liver abscess (brucelloma) in a young woman without previous remote brucellosis who presented with pronounced systemic and mild local symptoms. Brucelloma is the result of calcification of a granoulomatous reaction induced by persistent Brucella in macrophages. It represents a rare manifestation that follows previously undetected brucellosis. We describe the findings in plain radiograph, ultrasound, computed tomography, and magnetic resonance images. Together with the positive serology, imaging yielded important elements supporting the diagnosis. Modern radiological techniques also contributed to the final therapeutic management, preventing unnecessary laparotomy. Sequencing confirmed the definite diagnosis of Brucella melitensis as the causative factor.

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