Complications from gallstone disease is 0.3% per year and therefore prophylactic cholecystectomy are rarely indicated unless part of a special population that includes porcelain gallbladder, individuals eligible for organ transplant, diabetics and those with sickle cell anemia. Diagnosis
Diagnosis is guided by the persons presenting symptoms and laboratory findings. The gold standard imaging modality for the presence of gallstones is ultrasound of the right upper quadrant. There are many reasons for this choice, including no exposure to radiation, low cost, and availability in city, urban, and rural hospitals. Gallstones are detected with a specificity and sensitivity of greater than 95% with ultrasound. Further signs on ultrasound may suggest cholecystitis or choledocholithiasis. Computed Tomography (CT) is not indicated when investigating for gallbladder disease as 60% of stones are not radiopaque. CT should only be utilized if other intra-abdominal pathology exists or the diagnosis is uncertain. Endoscopic retrograde cholangiopancreatography (ERCP) should be used only if lab tests suggest the existence of a gallstone in the bile duct. ERCP is then both diagnostic and therapeutic. Management
Medications
Initial management includes the relief of symptoms and correcting electrolyte and fluid imbalance that may occur with vomiting. Antiemetics, such as dimenhydrinate, are used to treat the nausea. Pain may be treated with anti-inflammatories, NSAIDs such as ketorolac or diclofenac. Opioids, such as morphine, less commonly may be used. NSAIDs are more or less equivalent to opioids. Hyoscine butylbromide, an antispasmodic, is also indicated in biliary colic.In biliary colic, the risk of infection is minimal and therefore antibiotics are not required.
A nipple adenoma is a rare benign tumour of the breast. The condition may also be known as :

Florid papillomatosis of the nipple
Florid adenomatosis
Subareolar duct papillomatosis
Erosive adenomatosis

Signs and symptoms
Nipple adenomas may be felt as a lump under the nipple or areola. They may come to attention because of nipple pain, ulceration, swelling or discharge. Diagnosis
Definition
A nipple adenoma is a type of intraductal papilloma that arises within the lactiferous ducts that are located within the nipple. Differential diagnosis
The microscopic appearance of a nipple adenoma can be mistaken for carcinoma. Other conditions that have similar symptoms and signs as nipple adenoma include Pagets disease of the breast, other intraductal papillomas, ductal carcinoma in situ (DCIS), syringomatous adenoma of the nipple and subareolar sclerosing duct hyperplasia. Imaging
Lesions of the nipple and areola, such as nipple adenoma, may be difficult to image clearly on routine mammogram or ultrasonography. Nipple adenomas can be imaged using magnetic resonance imaging (MRI) and conventional or MR ductogram. Biopsy
Once excised, the macroscopic appearance of nipple adenomas is of a poorly defined nodular mass. The microscopic appearance can be quite bizarre, and may be misinterpreted as a carcinoma. Nipple adenomas usually have a rounded outline at low magnification, and at higher magnification can be seen to consist of a haphazardly arranged mass of proliferating tubular structures composed of epithelial and myoepithelial cells within varying amounts of fibrous stroma. The epithelial cells are usually columnar, but the columnar epithelial cells can undergo apocrine or squamous metaplasia. Mitotic figures and necrosis are not commonly seen.