Duodenal stump after duodenal switch procedure confused with subhepatic abscess

BACKGROUND: Duodenal switch operation is an effective procedure in patients with pathologic transpyloric duodenogastric bile reflux and subsequent alkaline reflux gastritis. Despite its effectiveness duodenal switch remains an infrequently performed procedure for a selected subgroup of patients and therefore few physicians are familiar with the postoperative anatomic situs. METHODS: We report on a 37-old-female who received duodenal switch procedure. Shortly afterward she attended an external emergency department because of upper abdominal pain. There the duodenal stump was misdiagnosed as subhepatic abscess and she received interventional drainage which was located within the duodenal stump. RESULTS: Eventually we removed the ill-placed drainage and the patient recovered under conservative therapy. CONCLUSIONS: The aim of this short communication is to raise awareness of the changed anatomic situs in patients with suprapapillary bile diversion to prevent such dangerous misdiagnosis.