The Sump Syndrome describes a constellation of findings seen in some patients who have had surgery connecting the biliary system and small bowel.


Clinical features of the sump syndrome:

(1) history of surgery that connects the biliary system and small bowel (choledochoduodenostomy, cholechojejunostomy, hepaticojejunostomy, other)

(2) bile stasis

(3) reflux of bilio-enteric contents into the common bile duct

(4) ascending cholangitis with or without infectious complications (hepatic abscess, sepsis)

(5) absence of anastomotic stricture


Stagnant bile mixed with enteric contents can develop debris, stones and bacterial overgrowth.


The frequency of the sump syndrome varies with the various types of surgery. It is fairly common with a side-to-side choledochojejunostomy and uncommon with a Roux-en-Y hepaticojejunostomy with a long Roux loop.


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