Chimal María Fernanda, Morales Carlos Ernesto, Saucedo Eric Misael
General Surgery Residency Program, Mexican Faculty of Medicine, La Salle University Mexico, Hospital Angeles Mocel, Mexico City, Mexico.
Department of General Surgery, Hospital Angeles Mocel, Mexico City, Mexico.
Case Rep Gastroenterol. 2021 Mar 12;15(1):365-371. doi: 10.1159/000513397. eCollection 2021 Jan-Apr.
Bilioenteric anastomoses were common interventions before the rise of minimal invasion procedures, specifically, before endoscopic retrograde cholangiopancreatography. During a choledochoduodenostomy (CDS) the distal part of the common bile duct is excluded from the bile drainage and behaves as a "sump," a poorly drained part that works as a reservoir which is responsible of the development of complications of the bilio-pancreatic tract. The consequent sump syndrome is a rare medical complication that presents a diversity of symptoms, for which there is no well-defined diagnostic algorithm. We present the case of a 72-year-old male patient with multiple comorbidities. He presented to the ER because of recurrent episodes of cholangitis; after having obtained the patient's medical records, lab and image studies, the latter showed pneumobilia. After considering all the results plus the pneumobilia we suspect the presence of this uncommon complication of CDS. The patient was subjected to an unsuccessful endoscopic treatment followed by surgery, after which he showed signs of improvement and adequate evolution till hospital discharge.
在微创治疗兴起之前，尤其是在经内镜逆行胰胆管造影术出现之前，胆肠吻合术是常见的治疗手段。在胆总管十二指肠吻合术（CDS）中，胆总管远端被排除在胆汁引流之外，形成一个“贮液池”，即一个引流不畅的部位，它作为一个储存器，是胆胰管并发症发生的原因。由此产生的贮液池综合征是一种罕见的医学并发症，表现出多种症状，目前尚无明确的诊断算法。我们报告一例患有多种合并症的72岁男性患者。他因复发性胆管炎就诊于急诊室；在获取患者的病历、实验室检查和影像学检查结果后，后者显示有气肿性胆囊炎。综合所有结果以及气肿性胆囊炎，我们怀疑存在这种罕见的CDS并发症。该患者接受了内镜治疗但未成功，随后接受了手术，术后病情好转，直至出院时情况良好。
