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The most common site of infection is the lung.[1] New Zealand is classified as a low TB incidence country with ~300 new cases diagnosed per year.[2] Intra-abdominal TB is notorious for non-specific presentation without the classic B-symptoms of fevers, night sweats and weight loss. We present a 59 years-old female patient with a 5 days history of generalized abdominal pain, nausea and vomiting, anorexia and fevers. Gastroduodenal TB is uncommon, accounting for ~1-6% of all abdominal TB.[[3]] Common presenting symptoms are abdominal pain, distension, nausea and vomiting and diarrhoea. [Extracted from the article]

The article presents a case study of a 53-year-old menopausal woman with long-standing iron deficiency anaemia. An abdominal computed tomography showed a polypoid mass within the distal ileum, and underwent a successful laparoscopic resection of the small bowel containing the inverted Meckel's diverticulum and was discharged. The diagnosis was confirmed histologically, with no evidence of heterotopic gastric or pancreatic mucosa.

Aims: The aim of this study was to investigate the outcome of common bile duct stones (CBDS) in asymptomatic patients at laparoscopic cholecystectomy (LC) and intra-operative cholangiogram (IOC)., Methods: All patients undergoing LC and IOC at Te Whatu Ora - Health New Zealand Waikato between January 2017 and January 2022 were retrospectively reviewed. Electronic records were screened for asymptomatic CBDS. Exclusion criteria were hyperbilirubinaemia, gallstone pancreatitis, cholangitis and imaging-detected CBDS. IOC reports were reviewed to determine presence of CBDS. A second blinded review was undertaken by a radiologist. Outcomes were use of endoscopic retrograde pancreatography (ERCP), complications and readmission with retained CBDS., Results: Included were 1,297 patients undergoing LC and IOC. Of these, 150 (24.1%) patients had a positive IOC, of which 58 (38.7%) were asymptomatic. Attempted flushing of CBDS was employed in 49 cases, 10 successfully. Common duct exploration was successful in a further six out of seven cases. Of the remaining 42 patients, 18 were offered ERCP. Seven had no stone at endoscopy. Sixteen had imaging, revealing clear ducts in 14. The remaining two then had ERCP confirming choledocholithiasis. Eight patients were managed expectantly, of whom none required readmission with retained stones., Conclusion: Rates of retained asymptomatic stones after positive IOC were low. Acknowledging risks associated with intervention and low rates of readmission with retained CBDS, an expectant approach could be more readily considered., Competing Interests: Nil., (© PMA.)