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Case Reports
. 2021 Sep 20;11(5):667-669.
doi: 10.1080/20009666.2021.1949794. eCollection 2021.

Sump syndrome of the remnant common bile duct following a living donor liver transplant

Gordon Robbins  1 , Justin Brilliant  2 , Yuting Huang  3 , Jonah Rubin  1 , Eric Goldberg  4 , Zurabi Lominadze  4
Affiliations
Case Reports

Sump syndrome of the remnant common bile duct following a living donor liver transplant

Gordon Robbins et al. J Community Hosp Intern Med Perspect. .

Abstract

Sump syndrome - a collection of digested food, debris, stones, bile, and bacteria in a poorly drained, bile duct reservoir - occurs most commonly after a side-to-side choledochoduodenostomy. As choledochoduodenostomies are now less common, sump syndrome is more often characterized as a complication of Roux-en-Y hepaticojejunostomies; however, most cases occur at the hepaticojejunostomy anastomosis. We report a rare case of sump syndrome in the intra-pancreatic remnant common bile duct in a patient with primary sclerosing cholangitis following living donor liver transplant via Roux-en-Y hepaticojejunostomy. Our patient had a history of end-stage liver disease secondary to primary sclerosing cholangitis but presented with recurrent bacteremia and symptoms of acute cholangitis following her transplant. While this complication has not been reported in this population, we know that those with primary sclerosing cholangitis and those undergoing liver transplantation are at very high risk for biliary complications and strictures. Liver transplant is currently our only treatment for primary sclerosing cholangitis, and more than any other group, they are referred for living donor liver transplantation, preferably via Roux-en-Y hepaticojejunostomy. Thus, our patient's clinical scenario is not uncommon and demonstrates a source of serious infection of which providers must be aware.

Keywords: Bile duct diseases; cholangitis; endoscopic retrograde cholangiopancreatography; liver transplantation; sclerosing cholangitis.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Magnetic resonance cholangiopancreatography
Figure 2.
Figure 2.
Patient anatomy with CBD stricture
See this image and copyright information in PMC

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