title: Peptic ulcers accompanied with gastrointestinal bleeding, pylorus obstruction and cholangitis secondary to choledochoduodenal fistula: A case report.
abstract: Peptic ulcers are an extremely common condition, usually occurring in the stomach and proximal duodenum. However, cases of peptic ulcers accompanied with multiple complications are extremely rare and hard to treat. The present case reinforces the requirement for the early recognition and correct treatment of peptic ulcers accompanied with multiple complications. A 67-year-old man presented with recurrent abdominal pain, fever and melena. The laboratory results showed anemia (hemoglobin 62 g/l) and hypoproteinemia (23 g/l). Abdominal imaging examinations revealed stones in the gallbladder and right liver, with air in the dilated intrahepatic and extrahepatic bile ducts. Endoscopic retrograde cholangiopancreatography failed due to a deformed pylorus. The patient was finally diagnosed with peptic ulcers accompanied with gastrointestinal (GI) bleeding, pylorus obstruction and cholangitis secondary to a choledochoduodenal fistula during an emergency pancreatoduodenectomy, which was performed due to a massive hemorrhage of the GI tract. The patient recovered well after the surgery.
authors: Key Laboratory of Combined Multi-Organ Transplantation, Ministry of Public Health, Key Laboratory of Organ Transplantation, The First Affiliated Hospital of Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China; Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The First Affiliated Hospital of Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China.
authors: Bin
authors: B
authors: Xi
authors: Key Laboratory of Combined Multi-Organ Transplantation, Ministry of Public Health, Key Laboratory of Organ Transplantation, The First Affiliated Hospital of Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China; Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The First Affiliated Hospital of Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China.
authors: Jun-Jun
authors: JJ
authors: Jia
authors: Key Laboratory of Combined Multi-Organ Transplantation, Ministry of Public Health, Key Laboratory of Organ Transplantation, The First Affiliated Hospital of Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China; Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The First Affiliated Hospital of Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China.
authors: Bing-Yi
authors: BY
authors: Lin
authors: Key Laboratory of Combined Multi-Organ Transplantation, Ministry of Public Health, Key Laboratory of Organ Transplantation, The First Affiliated Hospital of Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China; Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The First Affiliated Hospital of Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China.
authors: Lei
authors: L
authors: Geng
authors: Key Laboratory of Combined Multi-Organ Transplantation, Ministry of Public Health, Key Laboratory of Organ Transplantation, The First Affiliated Hospital of Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China; Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The First Affiliated Hospital of Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China.
authors: Shu-Sen
authors: SS
authors: Zheng
keywords: cholangitis; choledochoduodenal fistula; duodenal ulcer; gastric ulcer; gastrointestinal bleeding; pyloric obstruction