A high index of suspicion based on clinical presentation is essential to diagnose M. fortuitum as a cause of soft tissue infection. Treatment involves aggressive surgical debridement and administration of combination antibiotics based on sensitivity, which should be continued for a period that will ensure complete healing and prevent recurrence.

Choledochal cyst should be considered in all patients below 40 years of age presenting with biliary colic, pancreatitis or recurrent cholangitis with associated dilatation of bile duct. Complete excision of the cyst with restoration of biliary-enteric communication by hepaticojejunostomy form the basis of ideal treatment.

Local application of formalin is a simple, safe, inexpensive and fairly effective outpatient treatment modality for chronic radiation proctitis.

P leomorphic adenoma is a benign salivary gland with potential for malignant transformation. When the malignant transformation occurs, the tumor develops a tendency for local recurrence and distant metastases and the histology of the tumor reflects all the cellular features of malignancy. However, there is an entity of pleomorphic adenoma which, while retaining benign histological features, tends to develop both local and distant recurrences despite adequate clearance at primary surgery. The reason for this remains unexplained and there is no predictor for this behavior. The rarity of its occurrence and inadequacy of information about its treatment prompted us to report our experience with one such case.

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A 61-year-old woman presented with recent history of cholangitis. On evaluation, she was found to have a type I choledochal cyst and a cholecystoduodenal fistula. She underwent excision of the choledochal cyst and disconnection of the fistula. In this case study, we present the diagnostic features and management of choledochal cyst associated with cholecystoduodenal fistula and a literature review of the condition.

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