Acute cholangitis in the context of Lemmel syndrome with signs of diverticulitis.

Here, we present the case of a 51-year-old male with pain in the right hypochondrium, jaundice, fever, chills and septic shock. A computed tomography (CT) scan showed a juxtapapillary diverticulum with inflammatory changes, which caused bile duct ectasia and left biliary radicals. We considered this to be a septic shock of a biliary origin due to the cholangitis associated with Lemmel syndrome, with signs of juxtapapillary diverticulitis.

Hepatic hydatidosis that debuts with a direct rupture to the pleural cavity.

We present the case of a patient with pain in the right hypochondrium, dyspnea, deterioration of his general condition and a positive anti-Echinoccocus antibodies test. Ultrasound and thoraco-abdominal computed tomography (CT) demonstrated a complex hepatic cystic lesion with a transdiaphragmatic fistulous tract trajectory, directed to the pleural space. The lesion was compatible with a complicated hydatid cyst with direct rupture to the pleural cavity. Treatment with albendazole prior to surgery was started.