Biliary Fistula
What is Biliary Fistula?
A biliary fistula is an abnormal connection that forms between the common bile duct and another structure in the body that contains bile. Biliary fistulas commonly occur in patients with biliary tract diseases, such as biliary atresia, primary sclerosing cholangitis, and gallbladder carcinoma.
The most common type of biliary fistula occurs between the common bile duct and the gastrointestinal (GI) tract, usually in the duodenum or jejunum. Other types of fistulas may link the duct to the liver or other segments of small bowel. In some cases, a biliary fistula can form between the duct and bladder, known as a vesicoenteric fistula.
Signs and Symptoms
The most common sign of a biliary fistula is pain in the upper right abdomen, or where the fistula is located. Other symptoms may include jaundice, fever, abdominal tenderness, nausea, vomiting, and swollen lymph nodes. Furthermore, patients may experience increased appetite, loss of appetite, fatigue, and weight loss.
Diagnosis
In order to diagnose a biliary fistula, your doctor may perform imaging tests such as an abdominal CT scan, an abdominal ultrasound, or an MRI. Blood tests may also be used to measure liver enzymes, and a cholangiography (X-ray of the bile ducts) may be used to detect the fistula.
Treatment
The treatment of a biliary fistula depends on the underlying condition causing the fistula. In some cases, your doctor may recommend:
- Surgery to repair the fistula
- Placement of a drainage tube in the common bile duct
- Medication to reduce inflammation
- Antibiotics to prevent infection
- Dietary changes
If you have been diagnosed with a biliary fistula, it is important to follow your doctor's instructions and keep all of your follow-up appointments. With proper treatment, most people with biliary fistulas can achieve a good prognosis.