Fistula involving portal vein and duodenum at the site of a duodenal ulcer in a patient after previous extrahepatic bile duct resection and brachytherapy.
Fistulas involving the portal venous system and gastrointestinal (GI) tract are rare. However, they can cause life-threatening GI hemorrhage. A case of a fistula between the main portal vein and the posterior wall of the duodenal bulb at the site of a duodenal ulcer in a patient who had previously undergone an extrahepatic bile duct resection and brachytherapy for mucinous cystadenocarcinoma is reported. Consideration should be given to this entity in the differential diagnosis of GI hemorrhage in patients with a history of previous major biliary surgery.
Povoski
Stephen  P
S
Department of Surgery, West Virginia University, Robert C Byrd Health Science Center, Morgantown, W VA, USA. povoski-1@medctr.osu.edu
Shamma'a
John  M
J
D000328:Adult; D017734:Bile Ducts, Extrahepatic / Q000601:surgery; D001918:Brachytherapy; D003138:Common Bile Duct Neoplasms / Q000601:surgery; D018282:Cystadenocarcinoma, Mucinous / Q000601:surgery; D013505:Digestive System Surgical Procedures / Q000009:adverse effects; D004378:Duodenal Diseases / Q000209:etiology*; D004381:Duodenal Ulcer / Q000150:complications*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006500:Hepatic Duct, Common / Q000473:pathology; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology*; D008297:Male; D011169:Portal Vein; D016157:Vascular Fistula / Q000209:etiology*