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Two cases of Clonorchis-associated cholangiocarcinoma are described along with their cholangiographic features to illustrate the spectrum of pathology ascribed to the injurious effects of the flukes on the bile duct epithelium. This includes adenomatous hyperplasia, extensive fibrosis, and carcinoma. The first case was also complicated by hepatic abscesses, left hepatic lobar atrophy, gastrobiliary and biliarocutaneous fistulae. The second case features an unusually dilated pancreatic duct containing pancreaticoliths that was found later to consist of hyperplastic bile duct epithelium, presumably carried by worm migration in the biliary tree. Liver sections from both patients showed typical features of hepatic clonorchiasis with the cancer. A knowledge of the wide spectrum of clinical presentation of clonorchiasis, particularly cholangiocarcinoma, might aid Western physicians in averting this serious sequela through prompt eradication of the helminthic infection and early recognition and treatment of its complications.

An unusual case of chronic abdominal ischemia is reported. The clinical picture was characterized by the presence of chronic abdominal pain, sitophobia, progressive weight loss, an epigastric bruit, and the endoscopic picture of "erosive gastroduodenitis." The clinical course progressed with the development of liver infarction, ischemic cholecystitis, and intestinal gangrene.

A patient with a choledochal cyst presenting solely with abdominal pain is described. The cyst was diagnosed by endoscopic retrograde cholangiography. The clinical, radiographic, and surgical features of this disorder are briefly reviewed and the need to consider this entity as a possible cause of obscure abdominal pain is stressed.

A patient with a choledochal cyst presenting solely with abdominal pain is described. The cyst was diagnosed by endoscopic retrograde cholangiography. The clinical, radiographic, and surgical features of this disorder are briefly reviewed and the need to consider this entity as a possible cause of obscure abdominal pain is stressed.