Harefuah
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Although pelvic inflammatory disease (PID) is a common complaint in young, fertile women, it is quite rare during pregnancy. Clinically it is characterized by abdominal pain, sometimes presenting as an acute abdomen with fever. ⋯ Since surgery during pregnancy in the presence of an infection leads to abortion in most cases, accurate diagnosis and appropriate treatment is of the greatest importance. A case of PID during pregnancy is presented.
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In 11 of 82 patients undergoing laparoscopic cholecystectomy, preoperative endoscopic retrograde cholangiopancreatography (ERCP) was performed. Indications were biliary pancreatitis in 5 and suspected common bile duct (CBD) stones in the other 6 (based on US or liver function tests, or both). The biliary tree was normal in 9 and laparoscopic cholecystectomy was performed. ⋯ Of the remaining 3 patients, 1 underwent sphincterotomy via ERCP and 3 weeks later, laparoscopic cholecystectomy. In the others, we intended to explore the CBD by laparoscopy, but had to resort to open cholecystectomy due to technical difficulties resulting from unsuspected acute cholecystitis. Based on our short experience, ERCP combined with laparoscopic cholecystectomy seems to be both safe and effective.