Choledochal cyst mimicking as choledocholithiasis: A case report and review of literature.

Choledochal cysts are rare congenital anomalies of the biliary system, mostly diagnosed during childhood. In adults, a lower incidence and symptom overlap with more common biliary conditions may hinder the diagnosis. This case study presents a 50-year-old female patient who presented with abdominal pain and multiple gallstones on ultrasonography which also showed a dilation of the common bile duct, presumably left by a stone that had already passed. However, the dilation still existed 3 days later, which raised suspicion of a choledochal cyst. Magnetic resonance cholangiopancreatography was performed, and following surgical consultation, the patient underwent a successful cyst excision by Roux-en-Y hepaticojejunostomy with a smooth recovery leading to hospital discharge. This case highlights the importance of considering choledochal cysts as one possible diagnosis in adults with biliary symptoms and the significance of the more specific imaging modalities such as magnetic resonance cholangiopancreatography.

Secondary Hemochromatosis Leading to Acute Coronary Syndrome in a Thalassemic Patient.

Thalassemia, a congenital hemoglobinopathy, is characterized by impaired erythropoiesis and peripheral hemolysis, leading to anemia. Thalassemia major, in particular, necessitates regular blood transfusions, resulting in iron accumulation in the body. Iron overload primarily affects the heart and can induce cardiac disorder, including defects in the pump and conduction system, which is one of the leading causes of mortality among thalassemics. The existing literature has revealed limited support for the occurrence of acute coronary syndrome (ACS) due to hemochromatosis. However, it does show that elevated troponin levels can be observed even in cases not associated with ACS. Here, we offer a rare case study of acute coronary syndrome in a patient with thalassemia major who also had elevated ferritin levels and abnormal troponin I values. The difficulty of cardiac problems in thalassemia major is highlighted by this case, as well as the necessity for more clinical attention and study to better comprehend and handle such instances.