Spontaneous choledochoduodenal fistula complicating peptic ulcer disease--a case report

Spontaneous choledochoduodenal fistula is a rare complication of peptic ulcer disease, the surgical therapy of which is generally directed towards the ulcer disease itself, in the form of vagotomy with antrectomy or gastrojejunostomy. The case reported herein is of a 40 year old man who presented with a spontaneous choledochoduodenal fistula which was successfully treated by a truncal vagotomy and posterior retrocolic gastrojejunostomy. Such procedures as cholecystectomy, common bile duct exploration and bilio-enteric reconstruction, should only be performed in the case of a biliary stricture, which occurs rarely.