Choledocoduodenostomy and The Sump Syndrome (6 of 10)

The sump syndrome is a rare but important complication of CD and choledochojejunostomy (CJ). The sump syndrome develops when the drainage of bile and gastrointestinal debris from the distal common bile duct is obstructed and bacterial infection takes place. Anastomotic stricture or stenosis has been noted as a possible cause of the obstruction. The partially digested debris itself is believed to cause intermittent partial or complete obstruction of the stoma, leading to stasis of the bile and food and subsequent bacterial proliferation as well as secondary stone formation. The newly formed stones may then also obstruct either the stoma or the papilla. Although some researchers have noted that coexisting papillary dysfunction (stenosis or stricture) plays an important role in the development of the sump syndrome, obstruction of the enterostomy is believed to be the major pathophysiological event.