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]
Entire Body System
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Asymptomatic
In asymptomatic patients with prior CDD, abdominal radiograph shows air in the biliary tree. [ncbi.nlm.nih.gov]
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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]
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Falling
That sounds more like a dead cat bounce after the sharp fall of 9.4 per cent in the last half of last year. [today.line.me]
Respiratoric
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Pneumonia
His hospital course was complicated by hospital-acquired pneumonia and severe alcohol withdrawal. [ncbi.nlm.nih.gov]
Gastrointestinal
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Recurrent Vomiting
vomiting for 2 days. [ncbi.nlm.nih.gov]
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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]
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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]
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Loss of Appetite
[…] of appetite, fever, and recurrent vomiting for 2 days. [ncbi.nlm.nih.gov]
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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]
Cardiovascular
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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]
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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]
Liver, Gall & Pancreas
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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]
Psychiatrical
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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]
Neurologic
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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
Serum
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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]