Hi all,
I am having recurrent bacteremia/sepsis for the past two years. I had an HAI pump placed and roux en y hepaticojejunostomy done in 2019. The sepsis incidents started in 2020. At first my doctors thought it was due to intra hepatic bile duct dilation and placed a drain in me. After a few uneventful months , the sepsis happened again. The drain was removed by then. I was on ursodiol after that and looks like that helped with the bile duct dilation. The latest scans shows that the dilation is much better. But I am still getting sepsis and one was as recent as last week. Now they think it could be because of the reflux of small bowel contents into the bilairy tree through roux en y limb as that's the only possibility they can think of. But none of the several CT scans, MRCPs, Small bowel series & HIDA scans show any reflux. So they are hesistant to go in an extend the roux en y limb, which is already 70 cm long without some sort of confirmation that it is causing it. I am completely at sea. On top of that, last two times it was ESBL E.coli which is pretty much resistant to all antibiotics except meropenem and ertapenem.
Anybody else experienced anything like this? Could we be looking at the wrong sources? Can HAI pump cause sepsis?
Thanks in advance for all your help.