Hepatic Abscess: A Rare Presentation of Sump Syndrome After Choledochojejunostomy

Abstract

Sump syndrome is a rare complication of choledochoenterotomy. Patients with sump syndrome often have abdominal pain, recurrent cholangitis, pancreatitis, malabsorption, fever, an abnormal liver function test, and, rarely, hepatic abscess. Roux-en-Y choledochojejunostomy or hepaticojejunostomy has been advocated to prevent sump syndrome. We report an 80-year-old man who presented with a hepatic abscess secondary to sump syndrome 26 years after a Roux-en-Y choledochojejunostomy for recurrent cholangitis. Sump syndrome should be considered for patients who underwent biliary diversion surgery, regardless of the type of procedure or time from surgery.

Delayed identification of compound heterozygous (Phe508del/Arg117His) cystic fibrosis variants in a patient awaiting liver transplantation

“…Sump syndrome is a rare complication of side-to-side choledochoduodenostomies, where bile, debris and refluxed duodenal contents accumulate in the distal common bile duct segment between the anastomosis and ampulla of Vater, creating a stagnant reservoir and increasing the risk of liver and biliary tree infections 36. Indeed, liver abscesses, including those culturing P. aeruginosa , have been reported in non-CF patients following choledochoduodenostomy 37 38…”