Spontaneous choledochoduodenal fistula in the absence of
primary biliary disease is a very unusual complication of
duodenal ulcer disease. In most cases it is diagnosed
incidentally, because it seldom gives clinical manifestations.
Although surgical approaches have been the treatment of
choice in the past, the use of modern antisecretory drugs
turns now management strategy to more controversial
issues, as the fistula per se is not an indication for surgery.
Three of our cases are reported herein and the literature
on choledochoduodenal fistula, secondary to a penetrating
duodenal ulcer is reviewed.
Keywords: Choledochoduodenal fistula, duodenal ulcer,