Chronic duodenal obstruction related to a congenital web is a rare anomaly that is sometimes difficult to diagnose preoperatively. A case of partial duodenal obstruction along with a foreign body by a congenital duodenal web in a 10-year-old girl is presented. She has had one year history of intermittent epigastric discomfort without nausea, vomiting and growth retardation. The studies including UGI series and gastroduodenoscopy disclosed a perforated web in the 2nd portion of the duodenum and a dark go stone just proximal to the web. Via a longitudinal duodenotomy across the web, the web was partly excised with preservation of ampulla of Vater and the duodenum was closed in transverse fashion. The aperture of ampulla of Vater was located at 7 o'clock direction of posterior surface of the duodenal web. This particular case reminds clinicians to consider a duodenal web in a youngster presenting with a longstanding foreign body in the duodenum as one of the underlying pathologies.

A case of primary hyperparathyroidism due to parathyroid adenoma is presented. A 14-y-o male came in with voiding difficulty. The intravenous pyelogram (IVP) demonstrated a stone at the proximal one third of the left ureter and marked hydronephrosis of the left kidney, and the Tc-99m sestamibi nuclear scan demonstrated an hot spot below the lower pole of the left lobe of the thyroid. Laboratory study demonstrated hypercalcemia (12.4mg/dL) and elevated parathyroid hormone (143.67pg/mL). The excised parathyroid gland which was located below the lower pole of the left lobe of the thyroid, turned out to be parathyroid adenoma, consisting of mainly chief cells. Postoperatively he complained of transient hypocalcemic symptoms, which resolved by administration of calcium preparation and vitamin D.