Cystic dilatation of the cystic duct: a new type of biliary cyst.

A case of a patient with a congenital cyst that was localized solely to the cystic duct is presented. We propose including this anomaly in the biliary cyst classifications, which currently include choledochal and intrahepatic and extrahepatic biliary cysts. The diagnosis and management of this new type of cyst in addition to other types of biliary cysts are discussed.

[Cystadenocarcinoma of the appendix. Report of a case]. / Cistadenocarcinoma del apéndice. Informe de un caso.

Primary adenocarcinoma of the appendix is an uncommon disease frequently diagnosed surgery. It has an occurrence between 0.01 and 0.11% of all appendectomized patients, and it is more often found in patients older than fifty years. Symptoms are usually similar to those seen in acute appendicitis. Some authors consider the mucocele of the appendix a primary carcinoma as it is related with obstruction of the appendix lumen followed by a cystic dilatation with mucosal changes, mucus hypersecretion and extension outside of the appendix. We present one case with abdominal pain, constipation, weight loss of 26 kg, and a mass localized in the right lower quadrant. An exploratory surgery showed a partially retroperitoneal mass of 15 by 20 cm, irregular, cystic, with mucus content and the appendix included in it. The mass was removed and appendectomy was performed. Postoperatively the patient did well. The final pathologic report was a cystadenocarcinoma of the appendix.

[Biliary ascariasis. Experience at the Dr. Manuel Gea Gonzáles General Hospital]. / Ascariasis biliar. Experiencia en el Hospital General Dr. Manuel Gea González.

Six cases of biliary ascariasis were treated at Dr. Manuel Gea González General Hospital in the last sixteen years. The patient population consisted of five female and one male subjects. With a median age of 39 years. Main clinical manifestations were abdominal pain mimicking biliary colic, nausea, vomiting and jaundice. Diagnosis was established during surgery in four patients and by means of abdominal sonogram and endoscopic retrograde cholangiopancreatogram in two cases. Cholecystitis diagnosis was considered preoperatively in three patients and cholangitis in another one. Five patients were operated on and in one case the worm was successfully removed with the endoscope. Only one patient was complicated with biliary peritonitis, hepatic abscess and reinfestation. No deaths occurred. Mexican literature published in the lasts 25 years is reviewed and the current state in diagnosis and treatment concerning this entity is discussed in this paper.