Cerebral toxoplasmosis in a human immunodeficiency virus (HIV) seronegative patient with liver cirrhosis.1Elroy Patrick Weledji, 2Frank Zouna1Department of Surgery, Faculty of Health sciences, University of Buea, Cameroon, W/Africa; Regional hospital Limbe, S.W. Region, Cameroon. E-mail: [email protected] of Medicine, Faculty of Health Sciences, University of Buea, Cameroon , W/Africa, Regional Hospital Limbe, S.W. Region, Cameroon. Email: [email protected] author : EP Weledji, Holy family foundation, Livanda Kongo Hill, lumpsum quarters, PO Box 126, Limbe, Cameroon. Tel 237699922144. Email: [email protected]

Although the spleen is frequently enlarged in association with systemic infection, splenic abscesses are rare. They result from direct or haematogenous spread, or when a haematoma becomes infected. We present a case of the rare splenic abscess in a low resource setting.

We present herein a hepaticoduodenotomy performed for a retained, impacted distal CBD stone in a low resource setting with a good outcome. This impacted stone had complicated an open cholecystectomy for acute cholecystitis by causing the dehiscence of the cystic duct stump as a result of distal biliary obstruction.

We present a case of obstructive jaundice without biliary stones. This was due to a sclerotrophic gallbladder causing compression (Mirizzi’s syndrome) or adhesions to the extrahepatic biliary tree, pain and recurrent cholecystitis. The jaundice resolved following cholecystectomy. Mirizzi’s syndrome should be suspected in a patient with cholecystitis and obstructive jaundice after a thorough clinical assessment have excluded the usual causes of these symptoms.