Open AccessSpontaneous proximal choledochoduodenal fistula, a rare complication of cholangiolithiasis
Author(s) -
Hongyan Wang,
Xinxin Yang,
Shaoju Guo
Publication year - 2020
Publication title -
revista española de enfermedades digestivas/revista española de enfermedades digestivas
Language(s) - English
Resource type - Journals
eISSN - 2340-4167
pISSN - 1130-0108
DOI - 10.17235/reed.2020.7074/2020
Subject(s) - medicine , epigastric pain , heartburn , duodenal bulb , complication , gastroenterology , fistula , tenderness , physical examination , bilirubin , surgery , gastritis , abdominal pain , reflux , stomach , vomiting , disease
A 65-year-old female with a history of chronic gastritis presented with repeat epigastric pain and heartburn after meals. A physical examination was unremarkable, other than a mild fever and epigastric tenderness. Laboratory data revealed leucocytosis of 11,340/μl with 86.8 % of neutrophils, elevated γ-glutamyltransferase at 282.1 IU/l and mildly abnormal AST 40.5 IU/l, ALT 74.9 IU/l, total bilirubin 30.4 μmol/l (direct bilirubin 9.4 μmol/l) and amylase 202 IU/l. A gastroscopy showed a 4 mm fistula on the anterior wall of the proximal duodenal bulb, without ulcerations and the patient was admitted for intravenous antibiotic therapy.