Publication

Mind the Sump! - Diagnostic Challenge of a Rare Complication of Choledochoduodenostomy

Journal Paper/Review - Nov 1, 2014

Units
Keywords
•Sump syndrome
•Biliary tract disease
•Cholangitis
•Choledochoduodenostomy
•Endoscopic retrograde cholangiopancreatography
•Complication
•Pneumobilia
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Citation
Zeuge U, Fehr M, Meyenberger C, Sulz M. Mind the Sump! - Diagnostic Challenge of a Rare Complication of Choledochoduodenostomy. Case Reports in Gastroentrerology 2014; 8:358-363.
Type
Journal Paper/Review (English)
Journal
Case Reports in Gastroentrerology 2014; 8
Publication Date
Nov 1, 2014
Pages
358-363
Publisher
Karger (Freiburg)
Brief description/objective

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.