As the simplest and the least morbid procedure, endoscopic stone retrieval should be attempted in the treatment of patients with Bouveret's syndrome. When it fails, surgical lithotomy consisting of simple enterotomy may solve the problem. Although cholecystectomy and cholecystoduodenal fistula breakdown is unnecessary in every case, conditions may urge the surgeon to perform such operations even though they carry high morbidity and mortality.
Popliteus muscle sesamoid bone, also known as cyamella, is an accessory ossicle that is located in the vicinity of the proximal musculo tendinous junction. While commonly seen in small mammals such as cats and dogs, its presence in humans is very rare. In this report, we present the radiological findings of the popliteus muscle sesamoid bone, incidentally detected in a 47-year-old male. CT and MRI features of this ossicle are described.
Actinomycotic hepatic abscess was diagnosed in a 46-year-old male driver from Ukraine presenting with the symptoms of malaise, loss of appetite, upper right quadrant pain, weight loss, and night sweats which had been present for last 2 months. Computed tomography (CT) of the abdomen revealed a hypodense mass in the left liver lobe which was suspected as hepatocellular carcinoma. Histopathological examination of the CT guided biopsy specimen yielded a diagnosis of actinomycotic abscess of the liver. Treatment with intravenous penicillin for 6 weeks followed by a course of oral penicillin for 14 weeks resulted in complete cure as evidenced by clinical improvement and radiological disappearance of the lesion.
Primary epiploic appendagitis is a rare entity that occurs due to torsion and inflammation of the epiploic appendages. Clinically, this entity may be mistaken for acute abdomen with resultant unnecessary surgery. In contrast to acute surgical abdomen, epiploic appendagitis usually does not require surgical treatment; most of the patients resolve with conservative management. Diagnosis can be achieved with imaging modalities of which computed tomography is the gold standard procedure. Herein, a patient who presented with acute abdomen like clinical picture, with the computed tomography demonstration of primary epiploic appendagitis, is presented.
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