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Post-choledochoenterostomy 'sump syndrome'.

M Miros1, P Kerlin, R Strong

  • 1Department of Gastroenterology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.

The Australian and New Zealand Journal of Surgery
|February 1, 1990
PubMed
Summary
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Sump syndrome, a rare complication of choledochoenterostomy, often presents as pain or cholangitis. Surgical or endoscopic intervention can effectively resolve symptoms in most patients.

Area of Science:

  • Gastroenterology
  • Surgical Complications
  • Hepatobiliary Surgery

Background:

  • Side-to-side choledochoenterostomy can lead to sump syndrome, a late complication.
  • This syndrome involves the accumulation of bile and debris in the common bile duct.

Observation:

  • Five patients presented with sump syndrome over five years.
  • Clinical presentations included pain, cholangitis, secondary septic arthritis, and hepatic abscess.
  • Endoscopic evaluation revealed small stomal size (<1 cm) and distal common bile duct stones or debris.

Findings:

  • Surgical duct clearance with choledochoduodenostomy closure or Roux-en-Y reconstruction was performed in four patients.
  • One patient underwent endoscopic sphincterotomy.
  • Four patients achieved complete symptom resolution post-intervention; one experienced a single, antibiotic-responsive cholangitis episode.

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Implications:

  • Early recognition and intervention are crucial for managing sump syndrome.
  • Surgical and endoscopic procedures offer effective treatment options.
  • Understanding the pathogenesis aids in preventing and treating this complication.