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Sakhri, J.; Youssef, Sabri; Skandrani, K.

doi:10.1023/a:1012384105644

Cited by 25 publications

(14 citation statements)

References 10 publications

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“…Pneumobilia occurs in only 14% to 58% of patients with CDF, and although helpful when present, its absence cannot exclude the diagnosis. 7 In our patient, abdominal computed tomography revealed pneumobilia and did not show gallstones or CBD stones. Abdominal sonography may show air in the biliary tree and is very helpful for differentiating a biliary-enteric fistula secondary to gallstones from one caused by CBD stones.…”

Section: Discussionsupporting

confidence: 45%

“…Surgery is needed for patients who have poorly controlled or excessively recurrent ulcer symptoms, major complications of ulcer such as hemorrhage, or, in the exceptional patient, obstruction with cholangitis or biliary obstruction. 1 , 7 , 11 Our patient had an obstruction due to a duodenal ulcer, which led to food impaction in the CBD. Ascending cholangitis developed from the impacted food material, and surgery was mandatory.…”

Section: Discussionmentioning

confidence: 85%

“…A barium imaging study may show a fistulous tract connecting the duodenum with the biliary tree. 7 , 8 Demonstration of an orifice discharging bile during endoscopy is the most reliable sign of a CDF. Endoscopic retrograde cholangiography via the fistula orifice has been reported.…”

Section: Discussionmentioning

confidence: 99%

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Cholangitis Secondary to Food Material Impaction in the Common Bile Duct through a Choledochoduodenal Fistula

et al. 2015

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Biliary-enteric communications caused by duodenal ulcers are uncommon, and choledochoduodenal fistula (CDF) is by far the most common type. Usually in this situation, food material does not enter the common bile duct because the duodenal lumen is intact. Here, we report a case in which cholangitis occurred due to food materials impacted through a CDF. Duodenal obstruction secondary to duodenal ulcer prevented food passage into the duodenum in this case. Surgical management was recommended; however, the patient refused surgery because of poor general condition. Consequently, the patient expired with sepsis secondary to ascending cholangitis.

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Section: Discussionsupporting

confidence: 45%

Section: Discussionmentioning

confidence: 85%

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Cholangitis Secondary to Food Material Impaction in the Common Bile Duct through a Choledochoduodenal Fistula

et al. 2015

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“…[23] Historically, duodenal deformity and biliary opacification during gastrointestinal barium studies identified CDF. [15]…”

Section: Discussionmentioning

confidence: 99%

“…Often impossible because of duodenal narrowing, endoscopy and ERCP may sometimes demonstrate CDF. [34]…”

Section: Discussionmentioning

confidence: 99%

Spontaneous pneumobilia revealing choledocho-duodenal fistula: A rare complication of peptic ulcer disease

Tonolini¹

2013

J Emerg Trauma Shock

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Spontaneous pneumobilia without previous surgery or interventional procedures indicates an abnormal biliary-enteric communication, most usually a cholelithiasis-related gallbladder perforation. Conversely, choledocho-duodenal fistulisation (CDF) from duodenal bulb ulcer is currently exceptional, reflecting the low prevalence of peptic disease. Combination of clinical data (occurrence in middle-aged males, ulcer history, absent jaundice and cholangitis) and CT findings including pneumobilia, normal gallbladder, adhesion with fistulous track between posterior duodenum and pancreatic head) allow diagnosis of CDF, and differentiation from usual gallstone-related biliary fistulas requiring surgery. Conversely, ulcer-related CDF are effectively treated medically, whereas surgery is reserved for poorly controlled symptoms or major complications.

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Parapapillary choledochoduodenal fistula associated with cholangiocarcinoma

Kuroki

Fukuda

Tajima

et al. 2005

J Hepatobiliary Pancreat Surg

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usually been diagnosed incidentally. 2 However, the treatment of asymptomatic parapapillary choledochoduodenal fistula remains controversial. We report herein a case of parapapillary choledochoduodenal fistula associated with cholangiocarcinoma and discuss the relationship between this anomalous condition and biliary carcinogenesis. Case reportAn asymptomatic 61-year-old Japanese woman was admitted to our hospital for further examination of a liver tumor detected by screening abdominal ultrasonography. Her family history was noncontributory. Although she had a history of diabetes mellitus of 10 years' duration, her history revealed no gallstone or gastroduodenal ulcer. She was afebrile on admission, and physical examination demonstrated no abnormalities. Laboratory data showed elevation of serum alkaline phosphatase, at 1188 U/l (normal range, 115-359 U/l) and glutamine-oxaloacetic transaminase, at 38 IU/l (normal range, 13-33 IU/l). Carcinoembryonic antigen was within the normal limit, and carbohydrate antigen 19-9 was elevated, at 2819 U/ml (normal range, Ͻ37 U/ml). Abdominal computed tomography (CT) revealed an irregularly contoured tumor, 4 cm in diameter, in the right hepatic lobe, and a dilated intrahepatic bile duct in the posterior segment of the liver. Pneumobilia was also noted in the intrahepatic bile duct. Enhanced CT showed that the tumor was slightly enhanced and involved the left branch of the portal vein (Fig. 1). Moreover, Swelling of multiple lymph nodes, in the hepatoduodenal ligament, pancreatic head, and abdominal para-aorta, was demonstrated. Duodenal fiberscopy revealed a fistula orifice 1.0 cm proximal to the orifice of the papilla of Vater. The orifice of the papilla of Vater was normal in shape (Fig. 2). Although we could not insert a cannulation tube into the orifice of Abstract Parapapillary choledochoduodenal fistula is a rare disorder. We herein report a case of parapapillary choledochoduodenal fistula associated with cholangiocarcinoma. A 61-year-old woman was admitted to our hospital for further examination of a liver tumor. She had no clinical symptoms, but computed tomography scans showed an irregularly contoured liver tumor which was histologically confirmed to be adenocarcinoma, by a needle biopsy examination. Duodenal fiberscopy revealed a fistula orifice 1.0 cm proximal to the orifice of the papilla of Vater, and endoscopic retrograde cholangiography through the fistula showed a communication to the common bile duct. Hypotonic duodenography demonstrated reflux of contrast material into the choledochoduodenal fistula. The bile sample collected from the common bile duct showed extremely high levels of pancreatic enzymes, including amylase, phospholipase-A2, and elastase-I. Furthermore, Helicobacter DNA was detected in bile by polymerase chain reaction (PCR) analysis. This experience suggests to us that parapapillary choledochoduodenal fistula may be a risk factor for biliary tract carcinoma, and surgical management is the treatment of choice for this rare condition, even when t...

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Cited by 25 publications

References 10 publications

Cholangitis Secondary to Food Material Impaction in the Common Bile Duct through a Choledochoduodenal Fistula

Cholangitis Secondary to Food Material Impaction in the Common Bile Duct through a Choledochoduodenal Fistula

Spontaneous pneumobilia revealing choledocho-duodenal fistula: A rare complication of peptic ulcer disease

Parapapillary choledochoduodenal fistula associated with cholangiocarcinoma

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