A Case of Choledochoduodenal Fistula

Hiroki Akamatsu, Kuniya Nakajima, Yasuo Matsuda, Masahiro Fujikawa, Syunichi Ito, Youichi Kume, Toyohiro Izukura

Department of Surgery, Otemae Hospital

Spontaneous internal biliary fistula is rare, its incidence being reported as 1 to 5 per cent of biliary system operations. A case of choledochoduodenal fistula is presented. The patient was a 54-year-old woman who was admitted complaining of upper abdominal pain and fever. The fistula was diagnosed preoperatively by means of an upper GI contrast series and endoscopic retrograde cholangiopancreaticography (ERCP). At the operation, cholecystectomy, division of the fistula and T-tube drainage were performed. She had mild liver dysfunction postoperatively but recovered soon. She was discharged 2 months after the operation. In addition to our case, 95 cases of choledochoduodenal fistula reported in the l0-year period from 1979 to 1988 were reviewed. There were no specific clinical symptoms. Abdominal pain, fever and jaundice were the most common. ERCP was the most useful diagnostic method, and its prevalence is thought to result in an increase in reports of this disease, especially parapapillary fistula.

Key words
internal biliary fistula, choledochoduodenal fistula, endoscopic retrograde cholaugiopancreaticograply

Reprint requests
Hiroki Akamatsu Department of Surgery, Ashiya Hospital
39-1 Asahigaoka-cho, Ashiya, 659 JAPA

Accepted
January 10, 1990

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