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

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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.

Abstract

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.

참고문헌 (11)

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  3. Topal U, "Choledochoduodenal fistula secondary to duodenal peptic ulcer. A case report", Acta Radiol, 38, pp.1007~1009 (1997)
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  6. Naga M, "Choledochoduodenal fistula: a rare sequel of duodenal ulcer", Endoscopy, 23, pp.307~308 (1991)
  7. Jaballah S, "Choledochoduodenal fistula due to duodenal peptic ulcer", Dig Dis Sci, 46, pp.2475~2479 (2001)
  8. H’Ng MW, "Spontaneous choledochoduodenal fistula secondary to long-standing ulcer disease", Singapore Med J, 44, pp.205~207 (2003)
  9. Wong WM, "Images of interest. Hepatobiliary and pancreatic: choledochoduodenal fistula secondary to duodenal ulcer disease", J Gastroenterol Hepatol, 19, pp.829~ (2004)
  10. Page JE, "Ulcerogenic choledochoduodenal fistula", Clin Radiol, 40, pp.58~60 (1989)
  11. Fowler CL, "Choledochoduodenal fistula: a rare complication of peptic ulcer disease", Am J Gastroenterol, 82, pp.269~271 (1987)

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