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Adenomas of the extrahepatic biliary tuce are rare and common bile duct adenomas are rare too. They may be pessile or pedunculated our patient was a 60 years old lady who presented with RUQ pain and jaundice so with impression of cholangitic under weat laparotomy, cholecystectomy, CBD explouation and choledochoduodestomy. During CBD exploration a 0.5×0.5 cm of CBD identified that excised. Histopathology confirmed the diagnosis of CBD adenoma and the patient discharged 6 days later with no complication.

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Pain is a symptom of disease and most diseases accompanied with pain, specially among hospitalized post-operative patients. Several drugs and routes of administrations have used for post operative pain control. We compared post op analgesic effects of Diclofenac suppository to intramuscular Pethedine in post op inguinal herniorrhaphy patients. This study is a clinical trial on 40 patients who were operated due to unilateral inguinal herniorrhaphy. They divided into two groups incidentally. In Diclofenac Na group each patient received 100 mg Diclofenac Na supp every 8 hours. In Pethedine group each patient received 0.5 mg/kg Pethedine, intramuscularly. Pain severity of the patients controlled for 24 hours with visual comparation method and mean pain severity compared among 2 groups in the first 24 hours. Mean pain severity difference of Pethedine groups patients compared to Diclofenac Na group was 6.10 with standard error of 3.57 with (P<0.212) had no meaningful difference during first post operative phase. We concluded that Diclofenac Na is a suitable substitute of 24 hours intramuscular Pethedine for post op pain relief.