Spontaneous Choledochoduodenal Fistula Due to Chronic Duodenal Ulcer—A Case Report

• Main Authors: Palaniappan. M, N. S. Kannan, JayaKarthik. Y, Karthikesh. S
• Format: Article
• Language: English
• Published: JCDR Research and Publications Pvt. Ltd. 2014-12-01
• Series: International Journal of Anatomy Radiology and Surgery
• Subjects: biliary enteric fistula; gastric outlet obstruction; jejunal diverticulae; pneumobilia
• Online Access: http://www.ijars.net/articles/PDF/2019/5-%2010769_CE(Anj%20)_F(Sh)_PF1(ANAK)_PFA(AK).pdf

Choledochoduodenal fistulas account for only 1-25% of biliary enteric fistulas cases. Only 5-6% of biliary enteric fistula cases are spontaneous associated with duodenal peptic ulcers and they appear with the signs and symptoms of the underlying peptic ulcer disease. The first sign of this abnormal biliary-enteric communication may be the presence of air in the biliary tree as seen on plain X-ray, ultrasound or CT of the abdomen. Treatment should be directed towards peptic ulcer disease relief rather than correction of choledochoduodenal fistula. Here we present a patient with chronic duodenal ulcer and spontaneous choledochoduodenal fistula, gastric outlet obstruction and multiple jejunal diverticulae treated with truncal vagotomy and posterior gastroenterostomy.