title: [Choledochoduodenal fistula of ulcer etiology].
abstract: BACKGROUND
  Choledochoduodenal fistulas are very rare and in most cases are caused by a long-lasting and poorly treated chronic duodenal ulcer. They may be asymptomatic or followed by symptoms of ulcer disease, by attacks of cholangitis or bleeding or vomiting in cases of ductoduodenal stenosis. The diagnosis is simple and safe, however treatment is still controversial. If surgery is the choice of treatment, local findings should be taken into consideration. As a rule, intervention involving closure of fistula is not recommended.
  
  
  METHODS
  The authors present a 60-year-old woman with a long history of ulcer disease who developed attacks of cholangitis over the last three years. Ultrasonography and CT showed masive pneumobilia due to a choledochoduodenal fistula. As there was no duodenal stenosis or bleeding, at operation the common bile duct was transected and end-to-side choledochojejunostomy was performed using a Roux-en Y jejunal limb. From the common bile duct, multiple foreign bodies of herbal origin causing biliary obstruction and cholangitis were removed. After uneventful recovery the patient stayed symptom free for four years now.
  
  
  CONCLUSIONS
  The performed operation was a simple and good surgical solution which resulted in complication-free and rapid recovery with a long-term good outcome.
authors.forename: Radoje
authors.initials: R
authors.lastname: Colović
authors.forename: Nikica
authors.initials: N
authors.lastname: Grubor
authors.forename: Mirjana
authors.initials: M
authors.lastname: Perisic
authors.forename: Marjan
authors.initials: M
authors.lastname: Micev
authors.forename: Stojan
authors.initials: S
authors.lastname: Latincić
authors.forename: Natasa
authors.initials: N
authors.lastname: Colović
mesh_terms: D001658:Biliary Fistula / Q000209:etiology* / Q000601:surgery; D002768:Choledochostomy; D004381:Duodenal Ulcer / Q000150:complications*; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology* / Q000601:surgery; D008875:Middle Aged