RT Journal Article
SR Electronic
T1 Massive upper gastrointestinal bleeding: a rare complication of cholecystoduodenal fistula
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e228654
DO 10.1136/bcr-2018-228654
VO 12
IS 5
A1 Dinesh Kumar Vadioaloo
A1 Guo Hou Loo
A1 Voon Meng Leow
A1 Manisekar Subramaniam
YR 2019
UL http://casereports.bmj.com/content/12/5/e228654.abstract
AB A biliary fistula which may occur spontaneously or after surgery, is an abnormal communication from the biliary system to an organ, cavity or free surface. Spontaneous biliary-enteric fistula is a rare complication of gallbladder pathology, with over 90% of them secondary to cholelithiasis. Approximately 6% are due to perforating peptic ulcers. Symptoms of biliary-enteric fistula varies widely and usually non-specific, mimicking any chronic biliary disease. Cholecystoduodenal fistula causing severe upper gastrointestinal (UGI) bleed is very rare. Bleeding cholecystoduodenal fistula commonly requires surgical resection of the fistula and repair of the duodenal perforation. We describe the case of a previously healthy older patient who initially presented with symptoms suggestive of UGI bleeding. Bleeding could not be controlled endoscopically. When a laparotomy was performed, a cholecystoduodenal fistula was discovered and bleeding was noted to originate from the superficial branch of cystic artery.