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Parapapillary Choledochoduodenal Fistula Associated with Carcinoma of the Papilla of Vater M. Tanaka 1 , S. Ikeda 1 , H. Yoshimoto 1 , H. Itoh 1 , K. Tasaka 2 1The First Department of Surgery, Faculty of Medicine, Kyushu University pp.685-690
Published Date 1982/6/25
DOI https://doi.org/10.11477/mf.1403108961
  • Abstract
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 Parapapillary choledochoduodenal fistula has been drawing increasing attention with recent advance in endoscopic retrograde cholangiopancreatography. Almost all patients hitherto reported had gallstones at diagnosis or by history, and their fistulas were considered to have been caused by spontaneous extrusion of a common bile duct stone. We have described four patients with this entity associated with carcinoma of the papilla, not with cholelithiasis. Two of these patients had jaundice, which was marked but suddenly disappeared in one and was slight and subsided further in the other. The remaining two patients showed no jaundice. Disappearance or absence of jaundice in the four patients seemed to be related to the presence of parapapillary choledochoduodenal fistula formed by direct penetration of the carcinoma (cases 2~4) or, possibly by piercing bile duct pressure posed on a weakness due to submucosal invasion of malignant cells (case 1).


Copyright © 1982, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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