Choledochoduodenal fistula: a complication of a penetrated duodenal ulcer.

A 44 year old man who had a 5-year history of recurrent duodenal ulcer with a choledochoduodenal fistula is reported. He showed bulbar stricture and was successfully treated with an truncal vagotomy and distal gastrectomy by Billroth II method, leaving the fistula intact. Choledochoduodenal fistula is an uncommon complication of penetrated peptic duodenal ulcer. Surgical treatment for duodenal ulcer has been recommended. Medical management with the recent anti-ulcer drugs for choledochoduodenal fistula also has been reported to gain good results.