[Skip to Content]
Sign In
Individual Sign In
Create an Account
Institutional Sign In
OpenAthens Shibboleth
Purchase Options:
[Skip to Content Landing]
Other Articles
March 24, 1962

Choledochoduodenal Fistula Secondary to Duodenal Peptic Ulcer: Case Report

Author Affiliations

Lake Worth, Fla.

JAMA. 1962;179(12):969-970. doi:10.1001/jama.1962.03050120000013c

THE PROXIMITY OF the posterior wall of the duodenal bulb to the common bile duct makes it surprising that peptic ulcer penetration leading to a fistula between them is such a rarity. Such a fistula, however, comprises only from 3.5% to 6% of internal biliary fistulae in reported series. We have been able to trace reports of only 40 cases in the literature since 1915.

The great majority of reports on choledochoduodenal fistula resulting from peptic ulcer have appeared in surgical journals, with subsequent surgery performed on most of the patients described. The consensus in these reports would indicate that surgical intervention is believed to be the choice procedure for this condition, as it unquestionably is in the far commoner cases of internal biliary fistulae secondary to biliary tract disease. Hutchings et al., for example, after presentation of 6 cases and review of the American literature, state categorically, "Surgical therapy

Hutchings, V. Z.; Wheeler, J. K.; and Puestow, C. B.:  Choledochoduodenal Fistula Complicating Duodenal Ulcer ,  Arch Surg 73:598-605 ( (Oct.) ) 1956.Crossref
McLeod, J. A.:  Biliary Tract Fistulae ,  Amer Surg 25:177-184 ( (March) ) 1959.
Waggoner, C. M., and Le Mone, D. V.:  Clinical and Roentgen Aspects of Internal Biliary Fistulas ,  Radiology 53:31-41 ( (July) ) 1949.
Jordan, P. H., and Stirrett, L. A.:  Treatment of Spontaneous Internal Biliary Fistula Caused by Duodenal Ulcer ,  Amer J Surg 91:307-313 ( (March) ) 1956.Crossref
Kyle, J.:  Choledochoduodenal Fistula Due to Duodenal Ulceration ,  Brit J Surg 46:124-127 ( (Sept.) ) 1958.Crossref
Koberle, F.:  Beitrag zur Kenntnis der auf Ulcusbasis entstandenem inneren Gallensfisteln ,  Arch Klin Chir 192:572, 1938.
Walker, G. L., and Large, A. M.:  Choledochoduodenal Fistula: Its Surgical Management ,  Ann Surg 139:510-516 ( (April) ) 1954.Crossref
Cogbill, C. L., and Roth, H. P.:  Choledochoduodenal Fistula: Report of Two Cases due to Duodenal Ulcer ,  Amer Surg 19:480-488 ( (May) ) 1953.
Tate, R. C., and Shaw, H.:  Choledochoduodenal Fistula ,  Amer Surg 18:443-448 ( (May) ) 1952.
Palmer, E. D.:  Clinical Gastroenterology , New York: Harper & Brothers, 1957.
Palmer, E. D.: Personal communication to the authors.
Bockus, H. L.:  Gastroenterology , Philadelphia: W. B. Saunders Company, 1946.
Bockus, H. L.: Personal comunication to the authors.