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Narendren A, Tsoi AH, Iqbal A, Glance S. Rare complication of peptic ulcer disease. Gut 2024; 73:1086-1141. [PMID: 38123973 DOI: 10.1136/gutjnl-2023-330867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 11/22/2023] [Indexed: 12/23/2023]
Affiliation(s)
- Ahthavan Narendren
- Department of Gastroenterology, Northern Health, Epping, Victoria, Australia
| | - Andrew H Tsoi
- Department of Gastroenterology, Northern Health, Epping, Victoria, Australia
| | - Afia Iqbal
- Department of Gastroenterology, Northern Health, Epping, Victoria, Australia
| | - Simon Glance
- Department of Gastroenterology, Northern Health, Epping, Victoria, Australia
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2
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Ming Q, Jun Y, Nai-wen L, Lei C, Yu-dong F, Shu-guang W. The management of a duodenal fistula involving the right hepatic duct: a rare case report. Front Med (Lausanne) 2024; 11:1346590. [PMID: 38362537 PMCID: PMC10867158 DOI: 10.3389/fmed.2024.1346590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/09/2024] [Indexed: 02/17/2024] Open
Abstract
The formation of an internal fistula between the biliary system and the gastrointestinal tract is a rare condition with various etiologies, predominantly associated with recurrent chronic inflammation of the biliary system and tumors. Patients with this condition may lack specific clinical manifestations, presenting with symptoms such as abdominal pain, fever, jaundice, or may show no clinical signs at all. Common types of internal fistulas include cholecystoduodenal fistula, cholecystocolonic fistula, and choledochoduodenal fistula. Among these, the right hepaticoduodenal fistula is extremely rare and seldom reported in clinical literature. We herein report a case of right hepaticoduodenal fistula and analyze its mechanism, treatment principles, and preventive measures through a literature review.
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Affiliation(s)
| | - Yang Jun
- Department of Abdominal Surgery, Guiqian International General Hospital, Guiyang, China
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3
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Del Toro C, Cabrera-Aguirre A, Casillas J, Ivanovic A, Scortegagna E, Estanga I, Alessandrino F. Imaging spectrum of non-neoplastic and neoplastic conditions of the duodenum: a pictorial review. Abdom Radiol (NY) 2023; 48:2237-2257. [PMID: 37099183 DOI: 10.1007/s00261-023-03909-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 03/30/2023] [Accepted: 03/31/2023] [Indexed: 04/27/2023]
Abstract
Given its crucial location at the crossroads of the gastrointestinal tract, the hepatobiliary system and the splanchnic vessels, the duodenum can be affected by a wide spectrum of abnormalities. Computed tomography and magnetic resonance imaging, in conjunction with endoscopy, are often performed to evaluate these conditions, and several duodenal pathologies can be identified on fluoroscopic studies. Since many conditions affecting this organ are asymptomatic, the role of imaging cannot be overemphasized. In this article we will review the imaging features of many conditions affecting the duodenum, focusing on cross-sectional imaging studies, including congenital malformations, such as annular pancreas and intestinal malrotation; vascular pathologies, such as superior mesenteric artery syndrome; inflammatory and infectious conditions; trauma; neoplasms and iatrogenic complications. Because of the complexity of the duodenum, familiarity with the duodenal anatomy and physiology as well as the imaging features of the plethora of conditions affecting this organ is crucial to differentiate those conditions that could be managed medically from the ones that require intervention.
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Affiliation(s)
| | | | - Javier Casillas
- Division of Abdominal Imaging, Department of Radiology, Leonard M. Miller School of Medicine, University of Miami Health System, 1611 NW 12Th Ave, West Wing 279, Miami, FL, 33136, USA
| | - Aleksandar Ivanovic
- Department of Diagnostic Imaging, Faculty of Medicine, Center for Radiology and MRI, Clinical Center of Serbia, Belgrade, Serbia
| | | | - Indira Estanga
- Division of Abdominal Imaging, Department of Radiology, Leonard M. Miller School of Medicine, University of Miami Health System, 1611 NW 12Th Ave, West Wing 279, Miami, FL, 33136, USA
| | - Francesco Alessandrino
- Division of Abdominal Imaging, Department of Radiology, Leonard M. Miller School of Medicine, University of Miami Health System, 1611 NW 12Th Ave, West Wing 279, Miami, FL, 33136, USA.
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4
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Uhe I, Litchinko A, Liot E. Peptic ulcer disease complicated with choledocho-duodenal fistula and gastro-intestinal bleeding: a case report and review of the literature. Front Surg 2023; 10:1206828. [PMID: 37409067 PMCID: PMC10318342 DOI: 10.3389/fsurg.2023.1206828] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 06/08/2023] [Indexed: 07/07/2023] Open
Abstract
Peptic ulcer disease (PUD) is a very common condition, with an annual incidence ranging from 0.1% to 0.3% and a lifetime prevalence ranging from 5% to 10%. If not treated, it can lead to severe complications such as gastro-intestinal bleeding, perforation, or entero-biliary fistula. Entero-biliary fistulas and especially choledocho-duodenal fistula (CDF) are a rare, but relevant and important diagnosis, which can lead to several complications such as gastric outlet obstruction, bleeding, perforation, or recurrent cholangitis. In this article, we present the case of an 85-year-old woman with PUD complicated with gastro-intestinal bleeding and a CDF. We also performed a review of the literature to search for pre-existing cases with this atypical clinical presentation. The aim was to raise awareness among surgeons and clinicians by offering a summary of different types of entero-biliary and especially CDF, existing diagnostic investigations, and management.
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5
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AlZahrani S, AlMabadi B, AlZaharani A, Shariff MK. An Unusual Case of Choledochoduodenal Fistula Secondary to Peptic Ulcer Presenting With Cholangitis and Pneumobilia. Cureus 2023; 15:e40915. [PMID: 37496537 PMCID: PMC10366648 DOI: 10.7759/cureus.40915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2023] [Indexed: 07/28/2023] Open
Abstract
Choledochodoudenal fistula is an uncommon bilio-enteric fistula with clinical presentation ranging from having no symptoms to frank cholangitis. The causes of choledochodoudenal fistula are multiple, with bile duct stones being the most common. Duodenal ulcer is rarely the source of choledochodoudenal fistula. Clinical diagnosis defies acumen, and high-quality imaging including endoscopic or radiologic imaging is required for confirmation. Management of choledochodoudenal fistula is not standardized and remains challenging. We report an unusual case of a choledochodoudenal fistula caused by a duodenal ulcer that presented with pneumobilia and cholangitis. Treatment demanded medical, endoscopic, radiologic, and, ultimately, surgical intervention.
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Affiliation(s)
- Saad AlZahrani
- Digestive and Liver Center, King Abdullah Medical City, Makkah, SAU
| | - Bayan AlMabadi
- Digestive and Liver Center, King Abdullah Medical City, Makkah, SAU
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6
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Chen H, Wang B, Yang J, Wang C. IT COULD BE WORSE: A RARE CASE OF SPONTANEOUS CHOLEDOCHODUODENAL FISTULA WITH SUCCESSFUL DRAINAGE TO RELIEVE ACUTE SEVERE CHOLANGITIS. Gastroenterol Nurs 2023; 46:63-66. [PMID: 36706143 DOI: 10.1097/sga.0000000000000712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 07/08/2022] [Indexed: 01/28/2023] Open
Affiliation(s)
- Hong Chen
- Hong Chen, MS, is from the Department of Clinical Pharmacy, the 980th Hospital of the People's Liberation Army Joint Service (Bethune International Peace Hospital), Shijiazhuang, Hebei, China
- Biao Wang, MD, is from the Department of Endocrinology, Hospital of County Ningjin, Xingtai, Hebei, China
- Jie Yang, MD, is from the Outpatient Department, the Xicheng 4th Rest Center for Retired Cadres of Beijing Garrison Area of PLA, Beijing, China
- Chunhua Wang, MD, is from the Department of Gastroenterology, the 980th Hospital of the People's Liberation Army Joint Service (Bethune International Peace Hospital), Shijiazhuang, Hebei, China
| | - Biao Wang
- Hong Chen, MS, is from the Department of Clinical Pharmacy, the 980th Hospital of the People's Liberation Army Joint Service (Bethune International Peace Hospital), Shijiazhuang, Hebei, China
- Biao Wang, MD, is from the Department of Endocrinology, Hospital of County Ningjin, Xingtai, Hebei, China
- Jie Yang, MD, is from the Outpatient Department, the Xicheng 4th Rest Center for Retired Cadres of Beijing Garrison Area of PLA, Beijing, China
- Chunhua Wang, MD, is from the Department of Gastroenterology, the 980th Hospital of the People's Liberation Army Joint Service (Bethune International Peace Hospital), Shijiazhuang, Hebei, China
| | - Jie Yang
- Hong Chen, MS, is from the Department of Clinical Pharmacy, the 980th Hospital of the People's Liberation Army Joint Service (Bethune International Peace Hospital), Shijiazhuang, Hebei, China
- Biao Wang, MD, is from the Department of Endocrinology, Hospital of County Ningjin, Xingtai, Hebei, China
- Jie Yang, MD, is from the Outpatient Department, the Xicheng 4th Rest Center for Retired Cadres of Beijing Garrison Area of PLA, Beijing, China
- Chunhua Wang, MD, is from the Department of Gastroenterology, the 980th Hospital of the People's Liberation Army Joint Service (Bethune International Peace Hospital), Shijiazhuang, Hebei, China
| | - Chunhua Wang
- Hong Chen, MS, is from the Department of Clinical Pharmacy, the 980th Hospital of the People's Liberation Army Joint Service (Bethune International Peace Hospital), Shijiazhuang, Hebei, China
- Biao Wang, MD, is from the Department of Endocrinology, Hospital of County Ningjin, Xingtai, Hebei, China
- Jie Yang, MD, is from the Outpatient Department, the Xicheng 4th Rest Center for Retired Cadres of Beijing Garrison Area of PLA, Beijing, China
- Chunhua Wang, MD, is from the Department of Gastroenterology, the 980th Hospital of the People's Liberation Army Joint Service (Bethune International Peace Hospital), Shijiazhuang, Hebei, China
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7
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Zhang L, Jiang N, Jiang L, Liao R, Xiang L, Zhou B, Li D. A reinforced suture method for stapled gastrointestinal anastomosis to reduce gastrointestinal hemorrhage during Whipple operation in laparoscopy. Ann Surg Treat Res 2022; 102:110-116. [PMID: 35198514 PMCID: PMC8831092 DOI: 10.4174/astr.2022.102.2.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/27/2021] [Accepted: 12/03/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose Laparoscopy is being increasingly accepted for pancreaticoduodenectomy. Stapled anastomosis (SA) is used extensively to facilitate laparoscopic pancreaticoduodenectomy (LPD); however, the incidence of anastomotic bleeding after stapled gastrointestinal anastomosis is still high. Methods One hundred and thirty-nine patients who underwent LPD using Whipple method were enrolled in our study. We performed the SA with our reinforced method (n = 68, R method) and without the method (n = 71, NR method). We compared the clinical characteristics and anastomosis methods of patients with or without gastrointestinal-anastomotic hemorrhage (GAH), and operative parameters were also compared between the anastomotic methods. Results Of the 139 patients undergoing LPD, 15 of them developed GAH. The clinical characteristics of patients with or without GAH were not significantly different except in the anastomotic method (P < 0.001). In the univariate logistic regression analyses, only the anastomotic method was associated with GAH. Furthermore, patients with the NR method had significantly higher incidences of GAH (P < 0.001) and Clavien-Dindo grade ≥ III complications (P < 0.001). Conclusion Our retrospective analysis showed that the SA performed with reinforced method might be a reform of SA without the reinforcement, as indicated by the lower incidence of GAH. However, further research is necessary to evaluate the utility of this reinforced method.
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Affiliation(s)
- La Zhang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ning Jiang
- Department of Pathology, Chongqing Medical University, Chongqing, China
| | - Liujun Jiang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Rui Liao
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lei Xiang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Baoyong Zhou
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Dewei Li
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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8
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Kang H. Double Duodenal Major Papilla. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2021. [DOI: 10.4166/kjg.2021.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Huapyong Kang
- Division of Gastroenterology, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
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9
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Sreekumar S, Vithayathil M, Gaur P, Karim S. Choledochoduodenal fistula: a rare complication of acute peptic ulcer bleeding. BMJ Case Rep 2021; 14:e246532. [PMID: 34789532 PMCID: PMC8601065 DOI: 10.1136/bcr-2021-246532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2021] [Indexed: 11/04/2022] Open
Abstract
A 75-year-old man presented with a 3-week history of melaena and right upper quadrant pain. This was on a background of significant alcohol intake and a complex medical history. He was haemodynamically unstable with investigations indicating a new iron-deficiency anaemia. After resuscitation, urgent intervention was required under general anaesthesia. This involved a triple phase abdominal CT, followed by emergency oesophagogastroduodenoscopy. This revealed deep ulceration with extension to the pancreatic head and common bile duct. There was also evidence of pneumobilia on CT, secondary to a choledochoduodenal fistula. Treatment encompassed an invasive and medical approach. Following treatment, the patient was stable, with follow-up endoscopy exhibiting good duodenal mucosal healing.
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Affiliation(s)
| | - Mathew Vithayathil
- Imperial College London, London, UK
- Imperial College Healthcare NHS Trust, London, UK
| | - Pritika Gaur
- Imperial College Healthcare NHS Trust, London, UK
| | - Shwan Karim
- Imperial College Healthcare NHS Trust, London, UK
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10
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Zad M, Do CN, Teo A, Dixon E, Welch C, Karamatic R. Concurrent cholecystoduodenal fistula and primary aortoenteric fistula. Oxf Med Case Reports 2021; 2021:omab102. [PMID: 34729200 PMCID: PMC8557450 DOI: 10.1093/omcr/omab102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/31/2021] [Accepted: 09/22/2021] [Indexed: 11/12/2022] Open
Abstract
Bilioenteric fistulae are a rare complication and can pose a diagnostic challenge owing to non-specific symptomology. When occurring with an aortoenteric fistula, it represents a rare and potentially life-threatening disease state. We present the case of a 77-year-old gentleman initially treated as presumed ascending cholangitis. This was complicated by upper gastrointestinal bleeding secondary to an aortoenteric fistula and cholecystoduodenal fistula.
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Affiliation(s)
- Mohammadali Zad
- Gastroenterology, Caboolture Hospital, Caboolture 4510, Australia
| | - Cuong N Do
- General Medicine, Metro South Health Service, Brisbane 4102, Australia
| | - Andrew Teo
- Gastroenterology, Caboolture Hospital, Caboolture 4510, Australia
| | - Eliza Dixon
- General Medicine, Townsville Hospital and Health Service, Townsville 4814, Australia
| | - Christine Welch
- Gastroenterology, Townsville Hospital and Health Service, Townsville 4814, Australia
| | - Rozemary Karamatic
- Gastroenterology, Townsville Hospital and Health Service, Townsville 4814, Australia
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11
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Cao J, Hu Y, Jin S, Chen F, Li L, Huang H. Chronic cough caused by choledochoduodenal fistula: a case report. BMC Pulm Med 2021; 21:290. [PMID: 34507583 PMCID: PMC8434707 DOI: 10.1186/s12890-021-01658-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 09/02/2021] [Indexed: 12/04/2022] Open
Abstract
Background Chronic cough is characterized by cough as the only or main symptom, with a duration of more than 8 weeks and no obvious abnormality in chest X-ray examination. Its etiology is complex, including respiratory disease, digestive system disease, circulation system disease, and psychological disease. Although a set of etiological diagnosis procedures for chronic cough have been established, it is still difficult to diagnose chronic cough and there are still some patients with misdiagnosis.
Case presentation We present a case of a 54-year-old female patient who had chronic cough for 28 years. Physical examination had no positive signs and she denied any illness causing cough like tuberculosis, rhinitis. Recurrent clinic visits and symptomatic treatment didn’t improve the condition. Finally, gastroscopy identified the possible etiology of choledochoduodenal fistula that was proved by surgery. And after surgery, the patient's cough symptoms were significantly improved. Conclusion We report a rare case of chronic cough caused by choledochoduodenal fistula which demonstrates our as yet inadequate recognition of the etiology and pathogenesis. Written informed consent was obtained from the patient.
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Affiliation(s)
- Jiaofei Cao
- Department of Internal Medicine, The Second Affiliated Hospital of Medical School, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yue Hu
- Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Shaojun Jin
- Department of Emergency, Zhuji People's Hospital of Zhejiang Province, Shaoxing, China
| | - Fei Chen
- Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Li Li
- Second Affiliated Hospital, School of Medicine, Zhejiang University, No.599 Yanzhou Avenue, Jiande City, Hangzhou City, 311600, Zhejiang Province, China
| | - Huaqiong Huang
- Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
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12
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Duodenal-biliary fistula: An uncommon complication of duodenal ulcer disease. GASTROENTEROLOGIA Y HEPATOLOGIA 2021; 45:293-294. [PMID: 33727008 DOI: 10.1016/j.gastrohep.2021.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 01/09/2021] [Accepted: 02/01/2021] [Indexed: 11/20/2022]
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13
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Wang HY, Yang XX, Guo SJ. Spontaneous proximal choledochoduodenal fistula, a rare complication of cholangiolithiasis. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2020; 113:74-75. [PMID: 33207903 DOI: 10.17235/reed.2020.7074/2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A 65-year-old female with a history of chronic gastritis presented with repeat epigastric pain and heartburn after meals. A physical examination was unremarkable, other than a mild fever and epigastric tenderness. Laboratory data revealed leucocytosis of 11,340/μl with 86.8 % of neutrophils, elevated γ-glutamyltransferase at 282.1 IU/l and mildly abnormal AST 40.5 IU/l, ALT 74.9 IU/l, total bilirubin 30.4 μmol/l (direct bilirubin 9.4 μmol/l) and amylase 202 IU/l. A gastroscopy showed a 4 mm fistula on the anterior wall of the proximal duodenal bulb, without ulcerations and the patient was admitted for intravenous antibiotic therapy.
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Affiliation(s)
- Hong-Yan Wang
- Gastroenterology, Shenzhen Traditional Chinese Medicine Hospital , China
| | - Xin-Xin Yang
- Medical Imaging, Shenzhen Second People's Hospital, China
| | - Shao-Ju Guo
- Gastroenterology, Shenzhen Traditional Chinese Medicine Hospital, China
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14
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Yadav TN, Deo KB, Gautam S, Awale L, Pandit N. A Complicated Peptic Ulcer With Bleeding, Gastric Outlet Obstruction, and Choledochoduodenal Fistula. Cureus 2020; 12:e11189. [PMID: 33269120 PMCID: PMC7703711 DOI: 10.7759/cureus.11189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Although peptic ulcer disease (PUD) is a common entity, the rate of its complication has decreased with the advent of proton pump inhibitors. We present a case of complicated PUD in a 49-year-old male patient having a rare combination of bleeding, gastric outlet obstruction, and a large choledochoduodenal fistula (CDF) who presented with shock. After resuscitation and investigations, ligation of bleeder via duodenotomy, Roux-en-Y choledochojejunostomy, and gastrojejunostomy was done for ulcer bleeding, CDF, and pyloric stenosis respectively. The patient improved after surgery. As with other emergency surgery, minimizing morbidity and mortality remains the principle of management. The best treatment in this situation irrespective of hemodynamic stability is surgery, which is a one-time and best treatment for bleeding, obstruction, and CDF.
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Affiliation(s)
- Tek N Yadav
- Surgery, B.P. Koirala Institute of Health Sciences, Dharan, NPL
| | - Kunal Bikram Deo
- Surgery/Surgical Gastroenterology, B.P. Koirala Institute of Health Sciences, Dharan, NPL
| | - Sujan Gautam
- Surgery, B.P. Koirala Institute of Health Sciences, Dharan, NPL
| | - Laligen Awale
- Surgery/Surgical Gastroenterology, B.P. Koirala Institute of Health Sciences, Dharan, NPL
| | - Narendra Pandit
- Surgery/Surgical Gastroenterology, B.P. Koirala Institute of Health Sciences, Dharan, NPL
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15
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Kabaria S, Patel KG, Ahlawat S. A Rare Complication of Peptic Ulcer Disease. Gastroenterology 2019; 157:936-937. [PMID: 31476297 DOI: 10.1053/j.gastro.2019.05.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 05/03/2019] [Accepted: 05/13/2019] [Indexed: 12/02/2022]
Affiliation(s)
- Savan Kabaria
- Division of Gastroenterology and Hepatology, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Kalpesh G Patel
- Division of Gastroenterology and Hepatology, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Sushil Ahlawat
- Division of Gastroenterology and Hepatology, Rutgers New Jersey Medical School, Newark, New Jersey
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16
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Kachi A, Kanj M, Khaled C, Nassar C, Bou Rached C, Kansoun A. Choledochoduodenal Fistula Secondary to Peptic Ulcer Disease: A Case Report. AMERICAN JOURNAL OF CASE REPORTS 2019; 20:398-401. [PMID: 30914631 PMCID: PMC6453551 DOI: 10.12659/ajcr.915600] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Patient: Female, 29 Final Diagnosis: Choledocho-duodenal fistula Symptoms: Abdominal pain • nausea • vomiting Medication: — Clinical Procedure: Gastro-jejunostomy • hepatico-jejunostomy Specialty: Surgery
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Affiliation(s)
- Antoine Kachi
- Department of General Surgery, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon.,Department of General Surgery, Geitaoui University Hospital, Beirut, Lebanon
| | - Mouhammad Kanj
- Department of General Surgery, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Charif Khaled
- Department of General Surgery, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Chady Nassar
- Department of General Surgery, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Charbel Bou Rached
- Department of General Surgery, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Alaa Kansoun
- Department of General Surgery, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
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17
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Chaouch MA, Nacef K, Ghannouchi M, Khalifa MB, Chaouch A, Abdelkafi M, Jerbi S, Boudokhane M. Choledochoduodenal fistula due to peptic duodenal ulcer diagnosed by X-barium meal study: interest of medical treatment. Pan Afr Med J 2018; 29:177. [PMID: 30050641 PMCID: PMC6057557 DOI: 10.11604/pamj.2018.29.177.15043] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 03/01/2018] [Indexed: 11/11/2022] Open
Abstract
Peptic ulcer complication has decreased over le last years. Spontaneous bilio-digestive fistulas, in the absence of primary biliary disease, remain a very unusual complication of the upper digestive tract. The choledochoduodenal fistula is an extremely rare entity which can be caused by a duodenal peptic ulcer. It appears with the symptoms of peptic ulcer disease. They are diagnosed incidentally on radiological exams. It was suspected after finding pneumobilia on abdominal ultrasound and confirmed by X-barium meals study. The purpose of this observation is to report the case of a patient presenting a choledochoduodenal fistula diagnosed by X-barium meal to underline the importance of this radiological exam to diagnose this disease and to insist on the conservative treatment for choledochoduodenal fistula caused by a duodenal peptic ulcer. The prognosis of patients treated medically is good, although the fistula can remain asymptomatic. Angiocholitis and biliary sequelae remain rare and do not warrant prophylactic surgical treatment.
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Affiliation(s)
| | - Karim Nacef
- Department of General Surgery, Tahar Sfar Hospital, Mahdia, Tunisia
| | | | | | - Asma Chaouch
- Department of General Surgery, Tahar Sfar Hospital, Mahdia, Tunisia
| | - Molk Abdelkafi
- Department of Radiology, Tahar Sfar Hospital, Mahdia, Tunisia
| | - Saida Jerbi
- Department of Radiology, Tahar Sfar Hospital, Mahdia, Tunisia
| | - Moez Boudokhane
- Department of General Surgery, Tahar Sfar Hospital, Mahdia, Tunisia
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B S B, Kar A, Dutta M, Mandal A, De Bakshi S. A case of choledochoduodenal fistula - an unusual case report. Clin Case Rep 2017; 5:1462-1464. [PMID: 28878904 PMCID: PMC5582229 DOI: 10.1002/ccr3.991] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Revised: 03/20/2017] [Accepted: 04/03/2017] [Indexed: 11/24/2022] Open
Abstract
Choledochoduodenal fistula (CDF) is an abnormal communication between the choledochus and the duodenum, accounts for 5–25% of all internal biliary fistulas. Here, we report a case of CDF secondary to chronic duodenal ulcer who presented with cholangitis. CDF is suspected in case of pneumobilia, and surgery is recommended for refractory cases.
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Affiliation(s)
- Bhaviya B S
- Department of General SurgeryCalcutta Medical Research InstitutekolkataWest BengalIndia
| | - Abhimanyu Kar
- Department of Surgical GastroenterologyCalcutta Medical Research InstitutekolkataWest BengalIndia
| | - Monalisa Dutta
- Department of General SurgeryCalcutta Medical Research InstitutekolkataWest BengalIndia
| | - Ajay Mandal
- Department of Surgical GastroenterologyCalcutta Medical Research InstitutekolkataWest BengalIndia
| | - Sanjay De Bakshi
- Department of Surgical GastroenterologyCalcutta Medical Research InstitutekolkataWest BengalIndia
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Choledochoduodenal fistula in the setting of Crohn's disease. Radiol Case Rep 2016; 11:309-312. [PMID: 27920850 PMCID: PMC5128396 DOI: 10.1016/j.radcr.2016.08.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 08/27/2016] [Accepted: 08/29/2016] [Indexed: 11/21/2022] Open
Abstract
Of all the spontaneous fistulas that occur between the extrahepatic biliary system and the intestine, a choledochoduodenal fistula is rarely seen. When it does occur, it is most often secondary to a perforated duodenal ulcer, choledocholithiasis, or cholelithiasis. It may also be seen following complications related to iatrogenic injury or tuberculosis. Generally, choledochoduodenal fistulas are asymptomatic, but may present with vague abdominal pain, fever, and other symptoms related to cholangitis. As a result, they can be difficult to diagnose clinically before imaging is obtained. We present a case of a 74 year old, asymptomatic, female with a past medical history significant for Crohn's disease who was found to have a choledochoduodenal fistula demonstrated on MRCP, possibly secondary to her underlying inflammatory bowel disease.
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