This Article Full Text (PDF) Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Magnus, W. E. Articles by Rhodes, J. Search for Related Content PubMed Articles by Magnus, W. E. Articles by Rhodes, J.

Choledochoduodenal Fistula Due to Duodenal Ulceration

X-ray Department, Kingston Public Hospital, Kingston, Jamaica

J. Rhodes, M.B., D.M.R.D.

X-ray Department, Central Middlesex Hospital, London, N.W.10

This excerpt was created in the absence of an abstract.

Perforation of a duodenal ulcer into the common bile duct is a relatively rare occurrence, in view of the great frequency with which ulcers on the posterior wall of the duodenal cap are diagnosed.

Scott, Pygott and Murphy (1954) reported ten personal cases of gas or barium in the biliary tract, together with a comprehensive list and review of recorded cases in which only 26 out of 181 cases of gas or barium in the biliary system were due to choledochoduodenal fistulae from all causes.

Three further cases of choledochoduodenal fistula due to duodenal ulceration are here reported. Case 3 is the first to be diagnosed radiologically in 29,619 consecutive barium meals performed at the Central Middlesex Hospital in a period of ten years. These three patients present most of the typical features of a choledochoduodenal fistula, as noted by Hutchings, Wheeler and Puestow (1956), whose article gave an excellent review of 30 cases in the American literature up to 1956, including six personal cases. These authors stressed that the majority of choledochoduodenal fistulae were secondary to duodenal ulceration in men, and presented in patients with symptoms referable only to the peptic ulceration and not with symptoms due to biliary disease. Two cases were reported by Heron (1958), including the rare occurrence of this condition in a woman.

C.M., a man aged 29, was admitted to Kingston Public Hospital, Jamaica, in February, 1957, following three haematemeses in the previous 36 hours.