Choledochoduodenal fistula due to peptic duodenal ulcer diagnosed by X-barium meal study: interest of medical treatment

Chaouch, Mohamed; Nacef, Karim; Ghannouchi, Mossab; Khalifa, Mohamed Ben; Chaouch, Asma; Abdelkafi, Molk; Jerbi, Saïda; Boudokhane, M.

doi:10.11604/pamj.2018.29.177.15043

Cited by 6 publications

(7 citation statements)

References 10 publications

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“…In another case, pneumobilia was observed incidentally in a patient presenting due to peptic ulcer symptoms persisting despite longterm medication. Cholecystoduodenal fistula was detected at endoscopy performed in order to identify the source of the pneumobilia [16]. In the present case, acute onset nausea and vomiting symptoms were attributed to food poisoning.…”

Section: Discussionmentioning

confidence: 66%

A rare case: Asymptomatic spontaneous pneumobilia

Yeniocak¹,

Az²,

Canipek³

et al. 2019

Journal of Surgery and Medicine

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Pneumobilia, or aerobilia, is defined as the presence of gas in the biliary system. It may occur for various reasons, including recent enterobiliary system interventions, sphincter of oddi dysfunction, and enterobiliary fistula and anastomoses. A 61-year-old male patient presented to our emergency department due to nausea and vomiting. He had no history of drug use other than proton pump inhibitor medication, nor of alcohol or substance use. Although no history of previous medical intervention was present, gas (pneumobilia) was detected in the intrahepatic biliary ducts. We suspected that the incidentally detected pneumobilia in this patient, who also suffered from food poisoning, developed spontaneously in association with peptic ulcer and might have derived from a thin, asymptomatic enterobiliary fistula. Depending on its cause, pneumobilia may not require emergency surgery. The possibility of enterobiliary fistula should not be overlooked in patients presenting to the emergency department with chronic peptic ulcer symptoms.

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Section: Discussionmentioning

confidence: 66%

A rare case: Asymptomatic spontaneous pneumobilia

Yeniocak¹,

Az²,

Canipek³

et al. 2019

Journal of Surgery and Medicine

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“…Moreover, the regenerative capacity of the bile duct wall post-thermal injury is limited, rendering self-repair challenging. Consequently, the bile duct wall loses its normal structure, leading to early bile leakage or delayed bile duct stenosis and subsequent biliary endocardial fistulas ( 7 ). Clinically, late-onset bile duct stenosis and biliary endocardial fistulas pose challenges for detection due to their insidious nature.…”

Section: Discussionmentioning

confidence: 99%

The management of a duodenal fistula involving the right hepatic duct: a rare case report

Ming,

Jun,

Nai-wen

et al. 2024

Front. Med.

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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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“…Diagnosing CDF mandates a high clinical suspicion and needs radiologic or endoscopic imaging to confirm. The presence of pneumobilia on plain X-ray, abdominal ultrasound, or CT scan should raise the suspicion of CDF; however, its presence is not universal [ 2 , 3 , 6 , 7 ]. EGD is another modality of investigation that can directly visualize the CDF and establish a cause such as PUD.…”

Section: Discussionmentioning

confidence: 99%

An Unusual Case of Choledochoduodenal Fistula Secondary to Peptic Ulcer Presenting With Cholangitis and Pneumobilia

AlZahrani,

AlMabadi,

AlZaharani

et al. 2023

Cureus

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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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Choledochoduodenal fistula due to peptic duodenal ulcer diagnosed by X-barium meal study: interest of medical treatment

Cited by 6 publications

References 10 publications

A rare case: Asymptomatic spontaneous pneumobilia

A rare case: Asymptomatic spontaneous pneumobilia

The management of a duodenal fistula involving the right hepatic duct: a rare case report

An Unusual Case of Choledochoduodenal Fistula Secondary to Peptic Ulcer Presenting With Cholangitis and Pneumobilia

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