The Challenges of Sump Syndrome: a Case Report and Literature Review

Sump syndrome is a rare complication of a side to side choledochoduodenostomy (CDD). After the introduction of endoscopic retrograde cholangiopancreatography (ERCP) in 1968 Kozarek (Gastroenterol Hepatol (N Y) 13(10):620-622, 2017), choledochoduodenostomy and its complications are seldom seen. The diagnosis of sump syndrome is further befogged by the lack of characteristic clinical or laboratory findings, the inability of the patient to provide medical records of their CDD, and the fact that sump syndrome only presents decades after a CDD. In this article, we will present a case of a 39-year-old female patient who presented as a case of ascending cholangitis with an initially unknown past surgical history. A detailed medical history was thoroughly taken, and her previous medical reports were presented after which an ERCP was done with extraction of debris was preformed. In a time where choledochoduodenostomy is rarely being chosen as a choice of treatment and its complications are infrequently encountered, this case serves as a reminder that even in the ERCP era, complications of choledochoduodenostomy should still be well understood.