Biliary intestinal fistula

Because biliary intestinal fistulas have no specific ~yrnptoms or physical signs, they are often overlooked mtil related complications occur. These complications it~clude gallstone iteus, obstruction of the common bile duct, cholangitis, hemorrhage from the fistula, :,nd obstruction of the small intestine or colon as a ~csult of extrinsic inflammation. The management of i~atients with biliary intestinal fistulas is therefore ~sually complex and often controversial. Whether or ,aot the fistula should be repaired during operations for gallstone ileus and what procedure to perform in cases in which a fistula is the result of peptic ulcer :~re examples of the problems in management. This p~per is a review and discussion of the etiology, associated complications, and management of twentytwo patients with biliary intestinal fistulas. Clinical Material