Association of peripapillary fistula with common bile duct stones and cholangitis.
BACKGROUND
Peripapillary choledochoduodenal fistula (PCDF) is occasionally detected during endoscopic retrograde cholangiopancreatography. Cholelithiasis and biliary bougienage are two suspected causes of PCDF.


METHODS
The medical records for 841 patients who underwent endoscopic retrograde cholangiopancreatography between 1993 and 2002 were reviewed for evaluation of PCDF.


RESULTS
A total of 327 patients had common bile duct stones, and 16 of these had a PCDF at the papilla of Vater. None of the 16 patients had a history of pancreatitis, duodenal ulcer, or had undergone endoscopic retrograde cholangiopancreatography previously. Seven of the 16 had not undergone biliary surgery.


CONCLUSIONS
This study indicates that PCDF is a relatively common complication of common bile duct stones and cholangitis. According to the present results, PCDF is more frequently associated with common bile duct stones than with biliary surgery and bougienage.
Karincaoglu
Melih
M
Department of Internal Medicine, Inonu University, Malatya, Turkey. mkarincaoglu@inonu.edu.tr
Yildirim
Bulent
B
Kantarceken
Bulent
B
Aladag
Murat
M
Hilmioglu
Fatih
F
D000368:Aged; D001658:Biliary Fistula / Q000209:etiology; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods; D002761:Cholangitis / Q000150:complications*; D042883:Choledocholithiasis / Q000150:complications; D002769:Cholelithiasis / Q000150:complications*; D003137:Common Bile Duct Diseases / Q000209:etiology*; D016154:Digestive System Fistula / Q000209:etiology*; D004106:Dilatation / Q000009:adverse effects; D004378:Duodenal Diseases / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies