title: Pneumobilia with gastric outlet obstruction.
abstract: Complications of peptic ulcer disease (PUD) like gastric outlet obstruction (GOO) and biliary fistula have become extremely rare with the advent of proton-pump inhibitors.This is a case of PUD presenting with GOO, a cholecystoduodenal fistula discovered incidentally on upper gastrointestinal endoscopy, and the presence of pneumobilia on a contrast-enhanced CT of the abdomen. A gastrojejunostomy with internal pyloric exclusion was performed. Since the patient did not have any signs of biliary tract disease,we decided not to operate on the fistula to prevent injury to the bile duct. The patient had an uneventful recovery.
authors.affiliation: Medical College Baroda, Vadodara, Gujarat, India.
authors.forename: Gaurav A
authors.initials: GA
authors.lastname: Kakked
authors.affiliation: Department of Surgery, SSG Hospital, Vadodara, Gujarat, India.
authors.forename: Nikita R
authors.initials: NR
authors.lastname: Bhatt
authors.affiliation: Department of Oncosurgery, Shubhechha Multispecialty Hospital, Vadodara, Gujarat, India.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Bhatt
mesh_terms: D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001660:Biliary Tract Diseases / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D017291:Clarithromycin / Q000627:therapeutic use; D064098:Esomeprazole / Q000627:therapeutic use; D015390:Gastric Bypass; D017219:Gastric Outlet Obstruction / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D006801:Humans; D007412:Intestinal Fistula / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000175:diagnosis* / Q000628:therapy; D019518:Postprandial Period; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D016896:Treatment Outcome; D014839:Vomiting / Q000209:etiology; D015431:Weight Loss
chemical_list: D000900:Anti-Bacterial Agents; D054328:Proton Pump Inhibitors; D000658:Amoxicillin; D017291:Clarithromycin; D064098:Esomeprazole