Internal biliary fistula is a rare condition as a complication of longstanding and advanced biliary disease or- peptic ulcer.
The fistulous tract is communicated between the gallbladder or bile ducts and nary all parts of the gastrointestinal tract and hollow abdominal viscrea.
The most common type in order given, are; cholecysto duodenal, cholecysto-colic, choledo choduodenal, and cholecysto-gastric fistula.
The preoperative diagnosis is very difficult probably due to no specific signs or symptoms which can be related to internal biliary fistula.
Most surgeons recommended surgical treatment for the biliary fistula which was come from gallstone.
However, there, is no consensus regarding the proper management of choledocho duodenal fistula up to now.
This report deals with 13 cases of internal biliary fistula which was treated in our institution during past 11 years 5 months from Jan. 1965 to May 1976.
There were 9 males and 4 females; the ages varied from 18 years to 62 years with average age of 46 years.
The most common symptoms were indigestion and pain in epigastrium and right upper abdo
The. type of internal biliary fistula were as followings; choledocho duodenal in 6 cases, cholecysto duodenal in 3 cases, cholecysto colic in I case, cholecysto gastric in 1 case, choledocho gastric in 1 case, site of unknown in 1 case.
The presumptive causes of the fistula were gallstone in 88 cases and peptic ulcer in 4 cases and remained 1 case was not confirmed.
Surgical treatment was carried out in 10 cases and 3 cases were improved with medical management.
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