Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc
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Case Report

Volume 3, Number 4, August 2012, pages 243-246

Choledochoduodenal Fistula Associated With Recurrent Peptic Ulcer


Figure 1.
Figure 1. Past endoscopic findings; 19 years old (left) and 32 years old (right).
Figure 2.
Figure 2. Abdominal computed tomography. Peumobilia in the intrahepatic bile duct (left) and dilatation of the stomach (right) was found.
Figure 3.
Figure 3. Upper gastrointestinal endoscopy. Duodenal ulcer and stricture was seen.
Figure 4.
Figure 4. Upper gastoduodenography. This revealed the existence of choledochoduodenal fistula.


Table 1. Laboratory Data
Cell count
RBC511 × 104/µl
Hb15.9 g/dl
Plt26.6 ×104/µl
WBC7,800 /µl
Blood gas analysis (room air)
paCO274 mmHg
paO270 mmHg
HCO366.3 mmol/l
TP8.1 g/dl
Alb5.4 g/dl
AST20 IU/l
ALT16 IU/l
LDH149 IU/l
AIP248 IU/l
γ-GTP23 IU/l
ChE5.44 U/ml
BUN61.8 mg/dl
Cr3.44 mg/dl
UA13.5 mg/dl
Na145 mEq/l
K2.9 mEq/l
Ca4.7 mEq/l
FBS96 mg/dl
CRP0.76 mg/dl