SUMP SYNDROME COMPLICATING ROUX-EN-Y HEPATICOJEJUNOSTOMY - CASE-REPORT AND REVIEW OF THE LITERATURE

Sump syndrome is a rare complication of biliary-enteric anastomosis. C lassically, the distal bile duct becomes obstructed by gastrointestina l debris after choledochoduodenostomy, resulting in cholangitis or, le ss commonly, pancreatitis. Obstruction of the biliary tree by gastroin testinal contents after Roux-en-Y choledochojejunostomy or hepaticojej unostomy has not been described in the English-language literature. Th is report details the diagnostic and operative management of the first patient with sump syndrome after hepaticojejunostomy. The presumed pa thophysiology was reflux of vegetable matter up the efferent limb, res ulting in hepatic duct obstruction and cholangitis. The patient ultima tely required complex choledochoscopic drainage of the intrahepatic bi liary tree and revision of the previous Roux-en-Y hepaticojejunostomy.