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Case Reports
. 2017 Aug 4;11(2):428-433.
doi: 10.1159/000477335. eCollection 2017 May-Aug.

Sump Syndrome: A Rare Long-Term Complication of Choledochoduodenostomy

Hrudya Abraham  1 , Sajan Thomas  1   2 , Amit Srivastava  3
Affiliations
Case Reports

Sump Syndrome: A Rare Long-Term Complication of Choledochoduodenostomy

Hrudya Abraham et al. Case Rep Gastroenterol. .

Abstract

Biliary sump syndrome is a rare condition. It is seen as a rare long-term complication in patients with a history of a side-to-side choledochoduodenostomy. In the era before endoscopic retrograde cholangiopancreatography, side-to-side choledochoduodenostomy was a common surgical procedure for the management of biliary obstruction. In the setting of a side-to-side choledochoduodenostomy, the bile does not drain through the distal common bile duct anymore. Therefore, the part of the common bile duct distal from the choledochoduodenostomy anastomosis consequently transforms into a poorly drained reservoir, making this so-called "sump" prone to accumulation of debris. These patients are prone to cholangitis. We present a 64-year-old man with a history of side-to-side choledochoduodenostomy who presented with manifestations of cholangitis. An endoscopic retrograde cholangiopancreatography confirmed a diagnosis of sump syndrome. The etiology, clinical manifestations, and treatment of biliary sump syndrome are discussed in this article.

Keywords: Choledochoduodenostomy; Complication; Sump syndrome.

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Figures

Fig. 1.
Fig. 1.
CT of the abdomen showing pneumobilia (arrow).
Fig. 2.
Fig. 2.
Endoscopic retrograde cholangiopancreatography image showing a sump and a mildly dilated common bile duct (arrow).
Fig. 3.
Fig. 3.
Endoscopic retrograde cholangiopancreatography – endoscopic view showing status post papillotomy (cross) and stent (arrow).
See this image and copyright information in PMC

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