Acute pancreatitis caused by impaction of hydatid membranes in the papilla of Vater: a case report

Acute pancreatitis is a rare complication of hydatidosis and the successful use of endoscopic sphincterotomy associated with extraction of hydatid membranes has been rarely reported. We describe a young man who developed acute pancreatitis after rupture of an echinococcus cyst, located at the left hepatic lobe, into the biliary tract. The cause of pancreatitis was confirmed by endoscopic retrograde cholangiopancreatography, which revealed the presence of a daughter cyst impacted in the major papilla. After sphincterotomy and removal of hydatid membranes from the biliary tract, the patient presented rapid resolution of pancreatitis and made an uneventful recovery

Severe dysphagia due to a huge epiphrenic diverticulum: long-term treatment with balloon dilation and botulinum toxin injection: a case report

We herein describe the first case of a high elderly patient with severe dysphagia in solids and liquids, caused by a huge epiphrenic diverticulum, who was treated with combined therapy of balloon dilation and botulinum toxin injection. Due to comorbid associated diseases the patient was unsuitable to withstand surgical or laparoscopic intervention. Treatment with botulinum toxin injection at the region of lower esophageal sphincter was unsuccessful. Combined therapy with balloon dilatation and botulinum toxin injection at the compressed part of esophageal lumen by the diverticulum resulted in improvement in dysphagia and malnutrition. During the long-term follow-up the patient developed symptomatic relapses, successfully treated by subsequent combined therapy resulting in longer-lasting symptom relief

Benign retropneumoperitoneum developed after endoscopic sphincterotomy and large balloon dilation of biliary sphincter for removal of large biliary stones: a case report

Biliary endoscopic sphincterotomy (ES) followed by biliary orifice dilation (BOD) with large-diameter balloons (> 12 mm) is a relative new technique for extraction of large biliary stones. However, the safety and the potential complications of this combined technique are not known yet. We present a patient who developed benign retroperitoneum after ES plus BOD with large-diameter balloon for removal of a large biliary stone, which was successfully treated conservatively. To the best of our knowledge this is the first report of such a complication after introduction of this method to clinical practice

Idiopathic portal hypertension in an "inactive" HBV carrier: a case report

Idiopathic portal hypertension belongs to the group of non-cirrhotic portal hypertension, its etiology is still unknown but its prognosis is excellent. We report a case of 45 year old female with inactive hepatitis B virus (HBV) carrier status and persistently elevated alpha-fetoprotein (AFP), presented with features of portal hypertension and without evidence of cirrhosis or fibrosis on liver biopsy

A variant of the double gallbladder. A possible cause of cholelithiasis?

Congenital duplication of the gallbladder is a rare anatomical malformation, which is usually discovered as an incidental finding during cholecystectomy. We report a case of a double gallbladder in a 45-year-old woman, which was discovered during laparoscopic cholecystectomy for symptomatic cholelithiasis. As it was not possible to identify the anatomical structures safely, the procedure was converted to open cholecystectomy. Inspection of the resected gallbladder showed that it consisted of 2 chambers with separate cystic ducts, which communicated through an ostium. Both chambers contained multiple gallstones. The inadequate drainage of the second chamber could be considered as a predisposing factor for the development of cholelithiasis in this case