RESUMO
Choledochoduodenal fistula (CDF) is an abnormal communication between the common bile duct and the duodenum. It accounts for about 5% to 25% of the total biliary fistulas and is usually due to a perforated duodenal ulcer, choledocholithiasis, and complications secondary to tuberculosis or could be iatrogenic. Primary intrabilliary tumors usually cause obstructive jaundice and rarely biliary metastasis arising from other organs like colon, breast, and lungs can cause obstructive jaundice. There has been a case report of metastasis from ovarian cancer to the major papilla of the duodenum but no reported cases of it causing a CDF. We report a rare case of an 83-year-old female with ovarian cancer who developed a metastatic lesion to the duodenum eventually resulting in a CDF.
Assuntos
Fístula Biliar/etiologia , Neoplasias Duodenais/secundário , Fístula Intestinal/etiologia , Neoplasias Ovarianas/patologia , Idoso de 80 Anos ou mais , Ampola Hepatopancreática/patologia , Colangiopancreatografia Retrógrada Endoscópica , Colangiopancreatografia por Ressonância Magnética , Ducto Colédoco/patologia , Neoplasias Duodenais/fisiopatologia , Endoscopia do Sistema Digestório , Feminino , Humanos , Tomografia Computadorizada por Raios XRESUMO
Tuberculosis (TB) is a great mimic of many diseases and may present a dilemma in diagnosis. Sebaceous cyst is the commonest swelling that occurs in the scrotal skin. We present a 23-year-old patient who presented with a painful hard scrotal skin nodule, clinically diagnosed to be an infected calcified sebaceous cyst, excised and reported to be due to TB. Nodular scrotal skin TB is extremely rare but should nonetheless be considered as a differential diagnosis in regions where it is prevalent. Thus, excision of any suspicious nodule is indicated.
