Choledocho-Duodenal Fistula as a Complication of a Chronic Duodenal Ulcer.

Abstract

Choledocho-duodenal fistulas are rare disorders that can be of various etiologies. Some of the most common causes of these fistulas are neoplastic processes in the extra-hepatic bile ducts, biliary stones or chronic duodenal ulcers. We will present the case of a patient with a choledocho-duodenal fistula who was treated in our clinic due to a severe episode of acute hepatitis. 
 We will present a case report as follow; a 52-year-old man was urgently brought to the abdominal surgery ward of the Tetovo Clinical Hospital due to severe pain in the right epigastric and subcostal region which also appears in the back region. It is accompanied by nausea, vomiting, sub-febrile fever, and weakness.
 The patient reports that he has long been treated with proton pump inhibitors such as pantoprazole due to a chronic duodenal ulcer…
 Conclusion; Choledocho-duodenal fistulas are very rare disorders and therefore pose a real challenge to surgeons and endoscopists in terms of their timely diagnosis. However, there are authors who prefer a conservative treatment, while some others suggest surgical intervention respectively fistulectomy, in order to prevent complications that may occur as a result of the regurgitation of duodenal contents in the bile duct.