A Rare Spontaneous Gastrobiliary Fistula

Fistulas between the extrahepatic bile duct and different abdominal organs are rare. Generally, these fistulas can be divided into spontaneous or iatrogenic and internal or external. It is assumed that 75% to 90% of all extrahepatic bile duct fistulas are spontaneous and develop as a result of cholecystolithiasis or choledocholithiasis. These fistulas develop as a complication of peptic ulcer in approximately 6% of cases, from neoplasia of the involved organs in about 4% of cases, and from iatrogenic causes in 9% to 23% of cases. The fistulas mostly arise in the small intestine (5075%), large intestine (0-20%), and other organs (5%), including the stomach, pancreas, kidneys, skin and bronchial tree.1-7 The first description of a spontaneous gastrobiliary fistula was published in 1965 and only a few cases have since been described.6,8-10 Here, we present a case report of a patient with a spontaneous gastrobiliary fistula. This rare complication of longstanding peptic ulcer disease was successfully treated by surgeons.