Edit concept Question Editor Create issue ticket

Sump Syndrome


Presentation

  • We present the case of a 64-year-old man with sump syndrome who presented with clinical signs of ascending cholangitis.[ncbi.nlm.nih.gov]
Pain
  • Recurrent abdominal pain, cholangitis, pancreatitis, or biliary obstruction 1.[radiopaedia.org]
  • It can present with a variety of symptoms and clinical pictures such as recurrent pancreatitis, colicky pain, jaundice, and cholangitis.[ncbi.nlm.nih.gov]
Asymptomatic
  • In asymptomatic patients with prior CDD, abdominal radiograph shows air in the biliary tree.[ncbi.nlm.nih.gov]
Physician
  • Management of the sump syndrome has been described as early as 1976 by physicians performing ERCP [ 6 ].[ncbi.nlm.nih.gov]
Fever
  • The vital signs were significant for high-grade fever (104 F), tachycardia (heart rate of 102 beats per minute), and hypotension (blood pressure of 95/65 mm Hg).[ncbi.nlm.nih.gov]
Pneumonia
  • His hospital course was complicated by hospital-acquired pneumonia and severe alcohol withdrawal.[ncbi.nlm.nih.gov]
Loss of Appetite
Epigastric Pain
  • pain radiating to the right upper quadrant of the abdomen, loss of appetite, fever, and recurrent vomiting for 2 days.[ncbi.nlm.nih.gov]
Vomiting
  • […] hepatic abscesses, alcohol abuse, history of cholecystectomy and revision of CBD (in 1980 in Mexico) presented to the emergency room with sharp epigastric pain radiating to the right upper quadrant of the abdomen, loss of appetite, fever, and recurrent vomiting[ncbi.nlm.nih.gov]
Tenderness in the Right Upper Quadrant
  • Physical examination was significant for tenderness over the right upper quadrant of the abdomen. The rest of the physical examination was within normal limits.[ncbi.nlm.nih.gov]
Tachycardia
  • The vital signs were significant for high-grade fever (104 F), tachycardia (heart rate of 102 beats per minute), and hypotension (blood pressure of 95/65 mm Hg).[ncbi.nlm.nih.gov]
Hypertension
  • Case Description A 64-year-old Hispanic man with a past medical history of type 2 diabetes, hypertension, dyslipidemia, benign prostatic hypertrophy, Parkinson's disease, multiple hepatic abscesses, alcohol abuse, history of cholecystectomy and revision[ncbi.nlm.nih.gov]
Jaundice
  • It can present with a variety of symptoms and clinical pictures such as recurrent pancreatitis, colicky pain, jaundice, and cholangitis.[ncbi.nlm.nih.gov]
Suggestibility
  • In symptomatic patients, plain film demonstration of calcification in the right upper quadrant or pneumobilia and debris-filled dilated biliary ducts suggests sump syndrome as clinical diagnosis.[ncbi.nlm.nih.gov]
Confusion
  • A few hours after admission to the hospital, the patient developed severe hypotension, hypoxia, and confusion. He was immediately transferred to ICU and was intubated.[ncbi.nlm.nih.gov]

Workup

Dyslipidemia
  • Case Description A 64-year-old Hispanic man with a past medical history of type 2 diabetes, hypertension, dyslipidemia, benign prostatic hypertrophy, Parkinson's disease, multiple hepatic abscesses, alcohol abuse, history of cholecystectomy and revision[ncbi.nlm.nih.gov]

Treatment

  • Treatment and prognosis Treatment typically involves endoscopic sphincterotomy, which allows decompression of the CBD distal to the level of ampulla 2. Reoccurrence is mainly due to heavy stone burden and stricturing disease.[radiopaedia.org]
  • The etiology, clinical manifestations, and treatment of biliary sump syndrome are discussed in this article.[ncbi.nlm.nih.gov]

Prognosis

  • Treatment and prognosis Treatment typically involves endoscopic sphincterotomy, which allows decompression of the CBD distal to the level of ampulla 2. Reoccurrence is mainly due to heavy stone burden and stricturing disease.[radiopaedia.org]

Etiology

  • The etiology, clinical manifestations, and treatment of biliary sump syndrome are discussed in this article.[ncbi.nlm.nih.gov]

Pathophysiology

  • According to Marbet et al. [ 13 ], reduced filling pressure as well as reduced peristalsis and drainage of the distal CBD caused by the upstream anastomosis play an important role in the pathophysiology of sump syndrome.[ncbi.nlm.nih.gov]

Prevention

  • A side-to-side choledochoduodenostomy is a procedure where a communication is formed between the mid-common bile duct and duodenum to prevent recurrent choledocholithiasis or biliary obstruction.[radiopaedia.org]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!