effect of stone size on the frequency of biliary pain

This study was aimed at assessing the relationship between cystic duct and stone diameter with the frequency of biliary pain A prospective study of 30 patients admitted for cholecystectomy due to symptomatic cholelithiasis. The pattern of their frequency of pain was recorded since the first attack until admission and related to the diameters of their gallbladder stones and cystic ducts.Patients with a cystic duct diameter of 5 mm or less had more frequent attacks of pain per week than those with a diameter more than 5 mm [p = 0.0003]. The smaller the cystic duct diameter, the smaller the stone diameter [p<0.0001], and the smaller the stone the more frequent are the attacks of pain [p = 0.0001]. This study showed that there is a significant relationship between the frequency of biliary pain and the size of stone and the diameter of cystic duct. This observation may give a useful clue to surgeons in arranging priorities for operations

use of in-office and emergency room ultrasonography in the diagnosis of cholelithiasis

The high accuracy rate of ultrasonography in the diagnosis of cholelithiasis has made it the diagnostic test of choice in this disease. We have studied the reliability of a surgeon doing in-office and emergency room ultrasonography to diagnose gallbladder stones in suspected cases using a portable ultrasound machine. The sensitivity of this approach is 96% and the specificity is 92%. To avoid delay and ensure faster management we recommend the use of in-office and emergency room ultrasonography in the diagnosis of gallstones

Macroscopic intrahepatic foreign body

A 55-year-old woman presented to the surgical out-patients clinic with an epigastric hernia. During routine investigations, her chest X-ray showed a sewing needle projecting to her epigastric area. Intraoperatively, the needle was found to be in the liver. The English literature is reviewed