Jain G K, Myelavagnam C, Hamid A, Allarakhia L
Med J Zambia. 1980 Apr-May;14(3):46-7.
A case of spontaneous choledocoduodenal fistula due to penetrating posterior duodenal ulcer is reported. The only presenting symptoms were pain and vomiting. There was no fever or recurrent jaundice which is usually expected in such a condition. The radiological findings included barium and air in the biliary tract. Biliary fistula are not uncommon. Although external biliary fistulae are seldom seen in present times, internal biliary fistulae are not a rare entity. Internal biliary fistulae are either spontaneous or due to operations on biliary tract. The common causes for spontaneous internal biliary fistula includes cholelithiasis, peptic ulceration and malignant neoplasm (Shiu) 1967. In a study of 819 cases by Waggoner and Le Mone (1949) 51% of such fistulae were cholecystoduodenal, 21% cholecystocolic, 19% choledocoduodenal, while the rest were choledocogastric and cholecystocholedocal. Most common cause for spontaneous choledocoduodenal fistula is due to gall stones, but, rarely posterior penetrating duodenal ulcer may also cause this condition. The following report concerns a spontaneous biliary fistula of the choledocoduodenal type, due to chronic duodenal ulcer.
本文报告一例因十二指肠后壁穿透性溃疡导致的自发性胆总管十二指肠瘘。仅有的临床表现为疼痛和呕吐。无发热或反复黄疸，而在这种情况下通常会出现这些症状。影像学检查发现包括胆道内有钡剂和气体。胆瘘并不少见。虽然目前很少见到外胆瘘，但内胆瘘并非罕见情况。内胆瘘可分为自发性或因胆道手术引起。自发性内胆瘘的常见原因包括胆石症、消化性溃疡和恶性肿瘤（Shiu，1967年）。在Waggoner和Le Mone（1949年）对819例病例的研究中，此类瘘管中51%为胆囊十二指肠瘘，21%为胆囊结肠瘘，19%为胆总管十二指肠瘘，其余为胆总管胃瘘和胆囊胆总管瘘。自发性胆总管十二指肠瘘最常见的原因是胆结石，但十二指肠后壁穿透性溃疡也可能罕见地导致这种情况。以下报告涉及一例因慢性十二指肠溃疡引起的胆总管十二指肠型自发性胆瘘。
