Chaouch Mohamed Ali, Nacef Karim, Ghannouchi Mossab, Khalifa Mohamed Ben, Chaouch Asma, Abdelkafi Molk, Jerbi Saida, Boudokhane Moez
Department of General Surgery, Tahar Sfar Hospital, Mahdia, Tunisia.
Department of Radiology, Tahar Sfar Hospital, Mahdia, Tunisia.
Pan Afr Med J. 2018 Mar 26;29:177. doi: 10.11604/pamj.2018.29.177.15043. eCollection 2018.
Peptic ulcer complication has decreased over le last years. Spontaneous bilio-digestive fistulas, in the absence of primary biliary disease, remain a very unusual complication of the upper digestive tract. The choledochoduodenal fistula is an extremely rare entity which can be caused by a duodenal peptic ulcer. It appears with the symptoms of peptic ulcer disease. They are diagnosed incidentally on radiological exams. It was suspected after finding pneumobilia on abdominal ultrasound and confirmed by X-barium meals study. The purpose of this observation is to report the case of a patient presenting a choledochoduodenal fistula diagnosed by X-barium meal to underline the importance of this radiological exam to diagnose this disease and to insist on the conservative treatment for choledochoduodenal fistula caused by a duodenal peptic ulcer. The prognosis of patients treated medically is good, although the fistula can remain asymptomatic. Angiocholitis and biliary sequelae remain rare and do not warrant prophylactic surgical treatment.
在过去几年中，消化性溃疡并发症有所减少。在无原发性胆道疾病的情况下，自发性胆-消化道瘘仍然是上消化道一种非常罕见的并发症。胆总管十二指肠瘘是一种极其罕见的病症，可由十二指肠消化性溃疡引起。它以消化性溃疡疾病的症状出现。它们在放射学检查中偶然被诊断出来。在腹部超声发现胆道积气后怀疑有该病，并通过X线钡餐检查得以确诊。本病例报告的目的是报告一例经X线钡餐诊断为胆总管十二指肠瘘的患者，以强调该放射学检查对诊断该病的重要性，并坚持对十二指肠消化性溃疡引起的胆总管十二指肠瘘采取保守治疗。药物治疗患者的预后良好，尽管瘘可能无症状。胆管炎和胆道后遗症仍然罕见，不需要预防性手术治疗。
