Roux loop obstruction following lateral pancreaticojejunostomy masquerading as recurrent pancreatitis.

Recurrent episodes of pain following pancreatic drainage is a perplexing problem often faced by the surgeon. The diagnosis and management of this entity is difficult. We report a case of Roux loop obstruction occurring 4 years after a lateral pancreaticojejunostomy (LPJ) for chronic pancreatitis.

Asymptomatic T-tube remnant in common bile duct.

A 46-year-old lady presented with itching, five years after a primary common bile duct repair following cholecystectomy. Prior to this she underwent an interno-external biliary drainage. At laparotomy the horizontal limb of a T-tube was found in the common hepatic duct. Eleven months after a Roux loop hepatico-jejunostomy she is asymptomatic.

Combined hepatocellular and cystadenocarcinoma presenting as a giant cyst of the liver--a case report.

Primary cystic lesions of the liver are very rare. Most of the solid tumours are hepatocellular carcinomas (HCC) with a smaller number being cholangiocarcinomas. The association of HCC with other primary liver malignancies is also extremely rare. This case report is about a 27 year old male patient who presented with a giant cystic lesion of the left liver. A CT scan showed a cystic lesion with internal septations and a thrombus in the main portal vein. The patient underwent an extended left hepatectomy and a portal venotomy with removal of the thrombus. Coexistent hepatocellular and cystadenocarcinoma were reported on histopathological examination. The patient was put on 5-FU postoperatively. He is doing well 11 months after surgery.

Superior mesenteric artery syndrome following ileo-anal pouch procedure.

A rare complication following ileo-anal pouch procedure is the occurrence of superior mesenteric artery syndrome. We report a patient with ulcerative colitis who developed vascular compression of the duodenum following J-pouch construction.

Segment IV liver cyst with biliary communication following laparoscopic deroofing.

Simple cysts of the liver rarely have a biliary communication. We record the development of a biliary communication following laparoscopic deroofing of a segment IV simple cyst of liver and document its successful sclerosis with tetracycline.

Angiosarcoma of cecum: unusual presentation with intussusception.

We report a 55-year-old man with angiosarcoma of the cecum who presented with generalized colicky abdominal pain with a mass in the periumbilical region. The lesion at surgery was a colo-colic intussusception extending to the midtransverse colon. A radical right hemicolectomy was done. Metastases to regional lymph nodes were noted in the specimen.