Twenty‐five cases of choledochal cysts operated at the University Hospital between 1969 and 1981 were reviewed. Nineteen of the patients were females. An accurate pre‐operative diagnosis of choledochal cyst was made in 10 patients (40%). We have found the 99Tcm‐diethyl‐IDA (EHIDA) scan to be the safest and most sensitive diagnostic tool. In recent years excision has been performed whenever possible in view of reports of malignancy developing in the cyst wall. It has a lower morbidity and re‐operation rate compared to internal drainage. In excision we advise the use of a cuff of the cyst wall for a wider anastomosis. As the biliary tract shrinks and retracts into the porta following excision of the cyst, stricture formation may still occur despite a wide anastomosis.

SUMMARY Sequential hepatobiliary scintigraphy using Tc‐99m‐diethyI‐IDA of an omphalopagus conjoined twins indicated the anatomic size, contour and position of fusion of the livers pre‐operatively. There was absence of significant cross‐circulation between the twins. It demonstrated separate gall bladders and biliary ducts which emptied into separate proximal duo‐denas. In addition, fusion of the proximal midgut from which separate ilea arose was shown. Separate kidneys and bladders were also demonstrated. This case illustrates a significant advantage of this non‐invasive technique over other methods in the evaluation of the anatomy and function of the liver and biliary system of omphalopagus conjoined twins.

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Giant lymph node hyperplasia is a benign condition and lesions have largely occurred in the thorax; it has rarely occurred in the pelvis. The case reported here appears to be the first in which this lesion occurring in the pelvis has obstructed vaginal delivery and required elective Cesarean section at term. The further management and a brief review of the literature are presented.