A case report on choledochoduodenal fistula: how to suspect this unusual entity?

Omar Sosa Sánchez; Yoselin Julisa Sarabia Perez; Cheryl Zilahy Diaz Barrientos; Monica Heredia Montano; Monserrat Ashanti Vela Ramos; Mildred Philippe Ponce

doi:10.18203/2320-6012.ijrms20241260

Authors

Omar Sosa Sánchez Department of General Surgery, University Hospital of Puebla, BUAP, Puebla, Mexico
Yoselin Julisa Sarabia Perez Department of General Surgery, University Hospital of Puebla, BUAP, Puebla, Mexico
Cheryl Zilahy Diaz Barrientos Department of General Surgery, University Hospital of Puebla, BUAP, Puebla, Mexico
Monica Heredia Montano Department of General Surgery, University Hospital of Puebla, BUAP, Puebla, Mexico
Monserrat Ashanti Vela Ramos Department of General Surgery, University Hospital of Puebla, BUAP, Puebla, Mexico
Mildred Philippe Ponce Department of General Surgery, University Hospital of Puebla, BUAP, Puebla, Mexico

DOI:

https://doi.org/10.18203/2320-6012.ijrms20241260

Keywords:

Choledochoduodenal fistula, Jaundice, Cholangitis, Endoscopic retrograde cholangiopancreatography

Abstract

A choledochoduodenal fistula is an abnormal connection between the common bile duct and the duodenum, which are associated with a history of problems in the common bile duct. It has appeared in 0.74% of patients submitted for biliary tract surgery. The most frequent symptoms of non-obstructive enteric biliary fistulas are: epigastric pain, cholangitis (80.91%), jaundice (54,.26%), fever (50.69%), nausea and/or vomiting (10.30%), abdominal distension (0.39%), asymptomatic (0.11%), and diarrhea (0.11%). Diagnostic imaging methods provide the data of greatest interest in revealing the presence of air in the bile duct. This method, as well as barium reflux under the biliary tree in contrasted studies and in ERCP, reveal the fistulous tract and its location. Neither the prevalence, nor the clinical characteristics that pertain to its presentation, are well known among our population. Possible treatments for this illness include conservative treatment with medication, endoscopic sphincterotomy, and surgical therapy.

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