title: Spontaneous hepaticoduodenal and choledochoduodenal fistula mimicking duodenal ulcer perforation, a very rare complication of transarterial chemoembolization.
abstract: Spontaneous bilo-enteric fistula is a rare complication following surgery or some therapeutic interventions such as transarterial chemoembolization (TACE). The present case was a young man, a known case of chronic hepatitis B with multiple recurrent hepatocellular carcinoma, who presented with clinical sepsis and jaundice. Computed tomography showed dilated proximal left intrahepatic ducts which suspected anastomotic stricture. He underwent endoscopic retrograde cholangiopancreatography, but the endoscopic view showed a deep ulcer covered by yellowish debris tissue. After re-evaluation it was found to be hepaticoduodenostomy and choledochoduodenostomy tracts. In the present case the fistula was suspected to be related to a previous TACE procedure.
authors: Siriraj Gastrointestinal Endoscopy Center, Division of Gastroenterology, Department of Internal Medicine, Siriraj Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand.
authors: Varayu
authors: V
authors: Prachayakul
authors: Liver and Digestive Institute, Samitivej Sukhumvit Hospital, Bangkok, Thailand.
authors: Pitulak
authors: P
authors: Aswakul
keywords: Choledochoduodenal fistula; Complications; Fistula; Hepaticoduodenal fistula; Transarterial chemoembolization