J Postgrad Med
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Cavernomatous transformation of the portal vein, seen in extrahepatic portal venous obstruction (EHPVO), can cause impingement or ischemic insult on bile ducts manifesting as "portal cavernoma cholangiopathy" (PCC). Bile duct wall calcification in portal biliopathy is a rare occurrence and has not been reported in the literature to the best of our knowledge. We report a 59-year-old male, a known case of EHPVO, who had undergone laparoscopic cholecystectomy, splenectomy, and splenorenal shunt in the past. ⋯ Calcifications were removed partially from the bile duct walls near choledochotomy site. With the anticipation of futile benefit from bilioenteric bypass, Roux-en-Y HJ was abandoned. Hepaticoduodenostomy was done to prevent bile leak from choledochotomy site.
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Once purely the domain of knee surgery, the use of computer-navigated techniques in total hip arthroplasty (THA) is becoming progressively more commonplace. As with the adoption of any new technology-assisted approach, the uptake of navigated THA utilization has heralded a new suite of technique-specific potential complications. ⋯ This case report describes the unusual circumstance of retained local bony debris generated through application of self-drilling, self-tapping iliac crest pins (for rigid navigation tracker placement) being mis-interpreted on advanced imaging - at a hospital site remote from the index surgery - as an aggressive, early-stage, chondrosarcomatous lesion. This case highlights the critical importance of both a general awareness of common imaging findings after navigated THA surgery (whereby tracker pins have been employed) and the value of 'hands on' clinical assessment of patients to allow correlation with suspicious imaging findings.