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Mind the sump! - diagnostic challenge of a rare complication of choledochoduodenostomy.

Authors
Type
Published Article
Journal
Case Reports in Gastroenterology
1662-0631
Publisher
S. Karger AG
Publication Date
Volume
8
Issue
3
Pages
358–363
Identifiers
DOI: 10.1159/000369298
PMID: 25520606
Source
Medline
Keywords
License
Unknown

Abstract

Sump syndrome is a rare long-term complication of side-to-side choledochoduodenostomy (CDD), a common surgical procedure in patients with biliary tract disease in the era before endoscopic retrograde cholangiopancreatography (ERCP). Frequently only pneumobilia, serving as sign for functioning biliary-enteric anastomosis, is reminiscent of the former surgery. We present the case of an 81-year-old patient with sump syndrome who presented with clinical signs of ascending cholangitis, decades after the initial CDD procedure. Finally the detailed medical history that was taken very thoroughly in combination with the presence of pneumobilia led to the suspicion of sump syndrome. Sump syndrome was diagnosed by ERCP, and after endoscopic debris extraction and antibiotic treatment the patient recovered quickly. In the ERCP era little is known about CDD and its long-term complications, especially by young colleagues and trainees. Therefore this report provides an excellent opportunity to refresh the knowledge and raise awareness for this syndrome.

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