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KMID : 0378019680110090067
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New Medical Journal
1968 Volume.11 No. 9 p.67 ~ p.74
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Roentgenological Observations on Air in the Biliary Track and Choledochoduodenal Fistulas
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柳浩濬/Yoo, H.J.
崔熙峰/田箕福/金倬/劉箕福/白樂道/Choi, H.B./Chun, K.B./Kim, T./Yoo, K.B./Paik, N.D.
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Abstract
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Air in the.biliary trail is an infrequent finding encountered in roentgenological examination of the abdomen, and it usually denotes presence of internal biliary fistula. The most common type..of spontaneous internal biliary fistula´ has - been known to be cholecystoduodenal ´ fistula -´(over 50 %); and choledochoduodena l fistula is said to account for only about one tenth to one-fourths of the cases reported in he literature.
The authors encountered 10 cases showing air in the biliary passages at Woo Sok University Hospital and Wonju Union Christian Hospital during the 8-year period from 1960 to 1967. There were´ 2 cases of incompetent ,´sphincter of Oddi. In one of these patients the common bile duct was found by operation to harbor 2 large stones and an ascaris worm. Five´ cases of choledochoduodenal fistula were seen. ` Three ´of them were believed to be.caused by calculous :perforation and two others _were attributed to duodenal ulcer.
In view of the facts that.the etiological factor in this type of spontaneous biliary fistula may influence the prognosis of. the patient, an attempt´ was made´ to -differentiate choledochoduodenal fistulas of calcuious , origin and those secondary to peptic ulcer. W the esae that there is an influx of barium into the normal-sized common bile duct from deformed duodenal bulb, the fistula -would be, most likely secondary to duodenal ulcer. On the other hand, if one observes-influx of barium into the dilated common duct, the fistula would be most certainly produced by passage of gallstone.
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