Imaging in sump syndrome: A rare complication of choledochoduodenostomy

Ravikanth, Reddy; Kamalasekar, Kanagasabai

doi:10.4103/ijri.ijri_427_18

Cited by 5 publications

(3 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Sump syndrome occurs secondary to the accumulation of food debris inside the infraanastomotic CBD with subsequent bacterial overgrowth. 25 Although its incidence was thought to decrease with end-to-side anastomosis, 5 we did not encounter any patients with that complication despite the majority of our patients being performed in the side-to-side fashion. The incidence of this syndrome ranged between 0% and 5.2%, according to previous studies, 19,23,24,26 and other studies denied the incidence of this complication, even with a longer follow-up period compared to ours.…”

Section: Discussionmentioning

confidence: 82%

Choledechoduodnostomy is an Optional Management for Choledocholithiasis; a Single Center Experience

Hasab Elnabi,

Ibraheem,

Hassan

et al. 2023

Ain Shams Journal of Surgery

View full text Add to dashboard Cite

Background: Endoscopic interventions are the mainstay treatment for choledocholithiasis. However, failure of stone extraction could be encountered in some cases. Also, some patients may have recurrent stones after previous endoscopic duct clearance. Choledechoduodenostomy (CDD) may be a good option for these patients. Herein, we present our experience regarding the safety and efficacy of CDD in the management of such patients. Patients and methods:We retrospectively reviewed the data of 30 consecutive patients who underwent the previous procedure in our tertiary care setting. Our main outcome was the incidence of short-and intermediateterm complications. Patients were followed for a minimum of 18 months after the operation.Results: Twenty-five patients were performed via the open approach, while the remaining five were performed by laparoscopy. The majority of cases (93.3%) had a side-to-side anastomosis, while only two cases had an end-toside anastomosis. Laparoscopy was superior to the open approach in blood loss and hospital stay. However, it was associated with a significantly prolonged operative time. Regarding postoperative complications, wound infection was the most common one (33.3%). Other early complications included abdominal collection (10%), bile leakage (6.7%), ileus (6.7%), and pulmonary embolism (3.3%). Late complications included cholangitis (6.7%), which responded to medical treatment. No patients with sump syndrome or anastomotic stenosis were encountered throughout the follow-up period. Conclusion:Apart from high wound infection rates, CDD is a feasible and effective procedure for the management of patients with choledocholithiasis, especially after the failure of the endoscopic methods.

show abstract

Section: Discussionmentioning

confidence: 82%

Choledechoduodnostomy is an Optional Management for Choledocholithiasis; a Single Center Experience

Hasab Elnabi,

Ibraheem,

Hassan

et al. 2023

Ain Shams Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…Biliary re ux post hepaticojejunostomy (Sump syndrome) is a rare life-threatening condition that leads to recurrent episodes of cholangitis. It can occur due to the accumulation of lithogenic bile, debris, or calculi as well as re uxed duodenal contents in the distal common bile duct (CBD) [19]. Although the mechanism is not completely understood it is thought to be due to a short Roux limb with re ux of food into the biliary tree and disturbance of intestinal motility [3].…”

Section: Discussionmentioning

confidence: 99%

Biliary Reflux Post-Hepaticojejunostomy (Sump Syndrome) Diagnosed using Microvascular Flow Imaging (MVI)—a Case Report

Sait

Benger

Yusuf

et al. 2022

SN Compr. Clin. Med.

View full text Add to dashboard Cite

Microvascular ow imaging (MVI) is a novel technique which provides detailed visualisation of ow in small vessels and structures and has a sensitivity comparable to contrast enhanced ultrasound (CEUS). The application of MVI has developed in several different areas including improved characterisation of liver lesions, breast masses, thyroid nodules, and musculoskeletal disorders. MVI is based on detecting movement rather than vascularity. We report a case of biliary re ux following Roux en Y hepaticojejunostomy (Sump syndrome) where MVI provided a detailed assessment of movement of uid

show abstract

“…The surgical options available to patients with refractory SS or those for which endoscopic treatment is not viable, are limited. Among the described techniques, we found sphincteroplasty with closure of the choledochoenterotomy, conversion to another biliary diversion such as a hepaticojejunostomy, or, as in our case, distal gastrectomy with Roux-en-Y gastrojejunostomy [ 4 , 9 , 14 , 15 ]. In each case, management must be individualized to break the reservoir-stasis-reflux and infection cycle, considering the anatomical modifications that each procedure represents along with the necessary post-surgical follow-up.…”

Section: Discussionmentioning

confidence: 99%

Don’t Forget about the Sump! An Uncommon Complication Many Years after a Choledochoduodenostomy

Chimal

Morales²,

Saucedo³

2021

Case Rep Gastroenterol

View full text Add to dashboard Cite

Bilioenteric anastomoses were common interventions before the rise of minimal invasion procedures, specifically, before endoscopic retrograde cholangiopancreatography. During a choledochoduodenostomy (CDS) the distal part of the common bile duct is excluded from the bile drainage and behaves as a “sump,” a poorly drained part that works as a reservoir which is responsible of the development of complications of the bilio-pancreatic tract. The consequent sump syndrome is a rare medical complication that presents a diversity of symptoms, for which there is no well-defined diagnostic algorithm. We present the case of a 72-year-old male patient with multiple comorbidities. He presented to the ER because of recurrent episodes of cholangitis; after having obtained the patient’s medical records, lab and image studies, the latter showed pneumobilia. After considering all the results plus the pneumobilia we suspect the presence of this uncommon complication of CDS. The patient was subjected to an unsuccessful endoscopic treatment followed by surgery, after which he showed signs of improvement and adequate evolution till hospital discharge.

show abstract

Imaging in sump syndrome: A rare complication of choledochoduodenostomy

Cited by 5 publications

References 4 publications

Choledechoduodnostomy is an Optional Management for Choledocholithiasis; a Single Center Experience

Choledechoduodnostomy is an Optional Management for Choledocholithiasis; a Single Center Experience

Biliary Reflux Post-Hepaticojejunostomy (Sump Syndrome) Diagnosed using Microvascular Flow Imaging (MVI)—a Case Report

Don’t Forget about the Sump! An Uncommon Complication Many Years after a Choledochoduodenostomy

Contact Info

Product

Resources

About