Spontaneous internal biliary fistulas are complications of biliary disease and may themselves be the source of further complications. Instances of the latter observed in a series of 28 bilio-digestive and 18 bilio-biliary forms are described: angiocolitis, biliary peritonitis, cholangitic cirrhosis, diarrhoea and malabsorption syndrome, haemorrhage, biliary ileus and Bouveret syndrome. Stress is laid on the need for early diagnosis and early surgery. It is pointed out that there is no such thing as an innocuous biliary calculus.
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