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

Publication

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

Journal Paper/Review - Nov 1, 2014

Zeuge Ulf, Fehr Martin, Meyenberger Christa, Sulz Michael

Units

Gastroenterology/Hepatology, Medizinische Onkologie und Hämatologie

Keywords

•Sump syndrome
•Biliary tract disease
•Cholangitis
•Choledochoduodenostomy
•Endoscopic retrograde cholangiopancreatography
•Complication
•Pneumobilia

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.