Joshi, AnipShakya, SamitaThapa, SurakshyaSultan, RifkaRajbhandari, AlishBaral, Priya2025-07-302025-07-302024https://hdl.handle.net/20.500.14572/1016Anip Joshi National Academy of Medical Sciences, Mahaboudha, Kathamandu, Nepal Samita Shakya National Academy of Medical Sciences, Mahaboudha, Kathamandu, Nepal Surakshya Thapa National Academy of Medical Sciences, Mahaboudha, Kathamandu, Nepal Rifka Sultan National Academy of Medical Sciences, Mahaboudha, Kathamandu, Nepal Alish Rajbhandari National Academy of Medical Sciences, Mahaboudha, Kathamandu, Nepal Priya Baral Ludwig Maximilian University, Geschwister-Scholl-Platz 1, Munich, GermanyAbstract Choledochoduodenal fistula is an abnormal connection between the common bile duct and the duodenum. The commonest cause is cholecystolithiasis, however, other causes are iatrogenic factors, bile duct stones (choledocholithiasis), and chronic duodenal ulcers. Here, we report a case of choledochoduodenal fistula secondary to long standing choledocholithiasis post cholecystectomy who presented with intermittent abdominal pain in the past three years which revealed choledochoduodenal fistula during Endoscopic Retrograde Cholangiopancreatography. As the patient had recurrent pain along with choledocholithiasis, surgical intervention was indicated. Choledochoduodenal fistula is suspected in case of recurrent cholangitis and surgery is recommended for refractory and complicated cases. Surgical treatment is also recommended for larger fistulas and especially with non-resolving medical treatment. This case highlights the treatment option for choledocholithiasis with choledochoduodenal fistula.Other