ABSTRACT
Objetivos: descrever o diagnóstico e tratamento de um caso de Síndrome Sump. Descrição do Caso: uma mulher de 33 anos vinha apresentando episódios recorrentes de dor abdominal, acompanhados de febre e calafrios. A paciente havia sido submetida previamente à cirurgia de vias biliares, sendo realizado o diagnóstico atual de Síndrome Sump. Optou-se pelo tratamento cirúrgico, diante da impossibilidade de tratamento endoscópico. Conclusões: a Síndrome Sump, entidade rara na atualidade, consiste em uma complicação da coledocoduodenoanastomose, causada pelo contato de resíduos gástricos com o colédoco distal, levando à sua obstrução. Deve ser lembrada como causa de colangite de repetição.
Aims: To describe the diagnosis and treatment of a case of Sump Syndrome. Case Description: A 33 years old woman presented recurrent episodes of abdominal pain accompanied by fever and chills. The patient had previously undergone surgery of the biliary tract, and the current diagnosis of Sump Syndrome was performed. A surgical treatment was indicated given the impossibility of endoscopic treatment. Conclusions: The Sump Syndrome, rare nowadays, consists of a complication of choledocoduodenoanastomosis caused by contact of gastric residues with the distal common bile duct, causing obstruction. It should be considered as a cause of recurrent cholangitis.
Subject(s)
Humans , Female , Anastomosis, Roux-en-Y , Cholangiopancreatography, Magnetic Resonance , Cholangitis , Choledochostomy , Abdominal Pain , Postcholecystectomy SyndromeABSTRACT
Sump syndrome is a rare late complication of choledochoenteric anastomosis, and this caused by the accumulation of food debris, choledocholithiasis, bile sludge and cholesterol crystals in the distal common bile duct. This syndrome is characterized by symptoms such as abdominal pain and fever. The treatment modality for this syndrome has been surgery in the past. However, endoscopic treatment such as endoscopic sphinterotomy is currently regarded as the primary therapeutic approach for this condition. We experienced a patient with a history of choledochoduodenostomy and who developed sump syndrome as a complication of the surgery. Endoscopic sphinterotomy was performed for treatment, but this only produced the recurrence of the disease. The recurrent sump syndrome was eventually successfully controlled by performing endoscopic papillary balloon dilatation.
Subject(s)
Humans , Abdominal Pain , Bile , Choledocholithiasis , Choledochostomy , Cholesterol , Common Bile Duct , Dilatation , Fever , Postcholecystectomy Syndrome , Recurrence , SewageABSTRACT
Sump syndrome is one of the late complications of a side to side choledochoduodenostomy, but it is a rare malady. The anastomosis of the bile duct and small bowel results in exclusion of the distal limb of the common bile duct from drainage of bile with the potential formation of a sump. Food material and bile sludge may accumulate in distal segment of common bile duct and so this cause recurrent bile duct stones. Bezoars frequently result from disturbed passage of the gastrointestinal tract, especially after surgery, and it may develop various symptoms by irritating or obstructing the gastrointestinal tract. The bezoar accompanied with sump syndrome after choledochoenterostomy has not yet been reported in the literature. We report here on a case of small intestinal obstruction due to bezoars accompanied with sump syndrome.
Subject(s)
Bezoars , Bile , Bile Ducts , Choledochostomy , Common Bile Duct , Drainage , Extremities , Gallstones , Gastrointestinal Tract , Intestinal Obstruction , Postcholecystectomy Syndrome , SewageABSTRACT
PURPOSE: To evaluate the usefulness of laser cystectomy for the treatment of patients with dacryocystitis and sump syndrome. METHODS: Thirteen patients (13 eyes) diagnosed with acute or chronic dacryocystitis, and nine patients (9 eyes) who developed sump syndrome after dacryocystorhinostomy from 2005 to 2006 underwent laser cystectomy and endonasal dacryocystorhinostomy. RESULTS: Pain and swelling around the orbit improved immediately after the operation in patients with acute dacryocystitis, and all symptoms of sump syndrome disappeared by 1 month postoperatively. Epiphora reduced in all patients. During the follow-up period, functional nasolacrimal duct obstruction occurred in one eye and membranous obstruction developed in two eyes. In these two eyes with membranous obstruction, revisional surgery was performed successfully. No recurrence of dacryocystitis was noticed. CONCLUSIONS: Laser cystectomy with endonasal dacryocystorhinostomy is a simple and effective treatment modality for patients with dacryocystitis and sump syndrome that minimizes the risk of recurrence.
Subject(s)
Humans , Cystectomy , Dacryocystitis , Dacryocystorhinostomy , Eye , Follow-Up Studies , Lacrimal Apparatus Diseases , Nasolacrimal Duct , Orbit , Postcholecystectomy Syndrome , RecurrenceABSTRACT
PURPOSE: To investigate the incidence and importance of diagnosis of lacrimal sump syndrome after endonasal dacryocystorhinostomy (DCR). METHODS: A retrospective analysis was performed on 837 eyes in 732 patients, (male 196, female 536) who had undergone endonasal DCR between January 2001 and June 2004. Dacryocystography (DCG) was performed in those patients who had recurrent epiphora or symptoms of dacryocystitis without saline regurgitation on syringing. RESULTS: Among the 90 eyes (10.8%) who had recurrent epiphora after endonasal DCR, 8 eyes were diagnosed with lacrimal sump syndrome and this comprised 8.9% of the causes of DCR failure. CONCLUSIONS: Lacrimal sump syndrome should be considered in the case of patients with recurrent epiphora. However, normal syringing finding after endonasal DCR, and revision may relieve the patients's symptom.