ABSTRACT
One of the remote complications of choledochoduodenostomy is the formation of a biliary sack in the retroduodenal portion of the choledocho between anastomosis and the obstructed papilla. These results in the accumulation of gallstones and debris in the sack giving rise to pain, colics, infection, cholangitis and pancreatitis. Three cases are presented here: their main symptoms were pain and fever, without jaundice. The accurate diagnosis is carried out with E.R.C.P. which combines endoscopic visualization of anastomosis and papilla with probing and contrast injection in both of them. The definitive treatment was performed in two patients. One was treated surgically; the other using endoscopic papillotomy. The latter is recommended as the treatment of choice in the sump syndrome.
Subject(s)
Common Bile Duct Diseases/etiology , Gallstones/surgery , Adult , Aged , Cholangiopancreatography, Endoscopic Retrograde , Common Bile Duct Diseases/diagnosis , Common Bile Duct Diseases/surgery , Female , Humans , Middle Aged , Postoperative Complications , SyndromeABSTRACT
Una de las complicaciones alejadas de las coledocoduodenoanastomosis es la formacion de un saco biliar, en la porcion retroduodenal del coledoco entre la anastomosis y la papila obstruida. Esta da lugar a la acumulacion de calculos y restos alimenticios en dicho saco provocando dolores, colicos, infeccion, colangitis y pancreatitis. Se presentan tres casos: dolor y fiebre fueron sus sintomas predominantes. No tuvieron ictericia. El diagnostico de certeza se realiza con la E.R.C.P. que combina la visualizacion endoscopica de la anastomosis y papila con canulacion e inyeccion de contraste en ambas. El tratamiento definitivo se realizo en dos casos, uno quirurgico, el restante por papilotomia endoscopica, terapeutica esta ultima que los autores consideran de primera eleccion
Subject(s)
Adult , Middle Aged , Humans , Female , Cholestasis , Common Bile Duct , DuodenumABSTRACT
One of the remote complications of choledochoduodenostomy is the formation of a biliary sack in the retroduodenal portion of the choledocho between anastomosis and the obstructed papilla. These results in the accumulation of gallstones and debris in the sack giving rise to pain, colics, infection, cholangitis and pancreatitis. Three cases are presented here: their main symptoms were pain and fever, without jaundice. The accurate diagnosis is carried out with E.R.C.P. which combines endoscopic visualization of anastomosis and papilla with probing and contrast injection in both of them. The definitive treatment was performed in two patients. One was treated surgically; the other using endoscopic papillotomy. The latter is recommended as the treatment of choice in the sump syndrome.
ABSTRACT
Una de las complicaciones alejadas de las coledocoduodenoanastomosis es la formacion de un saco biliar, en la porcion retroduodenal del coledoco entre la anastomosis y la papila obstruida. Esta da lugar a la acumulacion de calculos y restos alimenticios en dicho saco provocando dolores, colicos, infeccion, colangitis y pancreatitis. Se presentan tres casos: dolor y fiebre fueron sus sintomas predominantes. No tuvieron ictericia. El diagnostico de certeza se realiza con la E.R.C.P. que combina la visualizacion endoscopica de la anastomosis y papila con canulacion e inyeccion de contraste en ambas. El tratamiento definitivo se realizo en dos casos, uno quirurgico, el restante por papilotomia endoscopica, terapeutica esta ultima que los autores consideran de primera eleccion
Subject(s)
Adult , Middle Aged , Aged , Humans , Female , Cholestasis , Common Bile Duct , DuodenumABSTRACT
1.897 patients with upper gastrointestinal bleeding (UGIB) were studied and the cause was diagnosed in 1.756 (92.6%). The most frequently found pathology was the acute bleeding gastropathy (24.5%). Considering the gastric duodenal and anastomotic ulcer as a whole, in 47.5% of the cases the ulcer was observed. Both pathologies together make out that 72 out of 100 patients with UGIB have bleeding due to an ulcer or gastritis. It comes out that the low incidence of neoplasy as a consequence of UGIB and that the 31% of the diagnosed pathology could not have been diagnosed by X-ray.
Subject(s)
Endoscopy/methods , Gastrointestinal Hemorrhage/diagnosis , Acute Disease , Duodenum , Esophageal and Gastric Varices/complications , Esophagus , Gastrointestinal Hemorrhage/etiology , Humans , Peptic Ulcer/complications , StomachABSTRACT
1.897 patients with upper gastrointestinal bleeding (UGIB) were studied and the cause was diagnosed in 1.756 (92.6
). The most frequently found pathology was the acute bleeding gastropathy (24.5
). Considering the gastric duodenal and anastomotic ulcer as a whole, in 47.5
of the cases the ulcer was observed. Both pathologies together make out that 72 out of 100 patients with UGIB have bleeding due to an ulcer or gastritis. It comes out that the low incidence of neoplasy as a consequence of UGIB and that the 31
of the diagnosed pathology could not have been diagnosed by X-ray.
ABSTRACT
1.897 patients with upper gastrointestinal bleeding (UGIB) were studied and the cause was diagnosed in 1.756 (92.6
). The most frequently found pathology was the acute bleeding gastropathy (24.5
). Considering the gastric duodenal and anastomotic ulcer as a whole, in 47.5
of the cases the ulcer was observed. Both pathologies together make out that 72 out of 100 patients with UGIB have bleeding due to an ulcer or gastritis. It comes out that the low incidence of neoplasy as a consequence of UGIB and that the 31
of the diagnosed pathology could not have been diagnosed by X-ray.
