title: Taking an Alternate Route Home: Stenting of Choledochoduodenal Fistula.
abstract: A 53-year-old male with adenocarcinoma of the rectum with metastasis to liver and porta hepatis region underwent biliary stenting due to aggressive distal common bile duct stricture. At the time of planned stent exchange, the guidewire could not be re-introduced, despite several techniques, including the SpyScope(®) system. A small fistula was noted by contrast fluoroscopy extending between proximal biliary tree/porta hepatis and the duodenal bulb, likely secondary to previous chemotherapy and radiation. A stent was placed in this fistula, as this was the only pathway available for biliary drainage.
authors.affiliation: Department of Internal Medicine, Penn State Hershey Medical Center, Hershey, PA.
authors.forename: JayaKrishna
authors.initials: J
authors.lastname: Chintanaboina
authors.affiliation: Department of Gastroenterology, Penn State Hershey Medical Center, Hershey, PA.
authors.forename: Abraham
authors.initials: A
authors.lastname: Mathew
authors.affiliation: Department of Gastroenterology, Penn State Hershey Medical Center, Hershey, PA.
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Moyer