A rare pancreaticobiliary complication of duodenal diverticula is Lemmel syndrome. Lemmel syndrome is defined as an obstructive jaundice. ABSTRACT. In Lemmel was the first to report the presence of juxtapapillary diverticula and hepatocholangiopancreatic disease, excluding cholelithiasis. Lemmel’s syndrome, juxtapapillary diverticula, periampullary duodenal In Lemmel was the first to report the presence of juxtapapillary.

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Extrinsic compression of the common bile duct may require surgery. In addition, the stomach and proximal duodenum were dilated with air-fluid levels concerning for proximal obstruction. Duodenal diverticulum causing intermittent-persistent cholestasis: MR cholangiopancreatography of Mirizzi syndrome and Lemmel syndrome. Lemmel’s syndrome as a rare cause of obstructive jaundice.

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After completion of enterolith removal, filling defect is no longer seen within the PAD C. During surgery, a 4 cm diverticulum was found on the posteromedial side of the second duodenal portion of the juxtapapillary duodenum, which was compressing the distal bile duct and contained food debris.

There was intra- and extra-hepatic biliary dilatation to the level of the ampulla. This article has been cited by other articles in PMC. Please review our privacy policy.


Lemmel Syndrome Secondary to Duodenal Diverticulitis: A Case Report

The clinical significance of the duodenal diverticulum Die klinische Bedeutung der Duodenaldivertikel. The most plausible explanation is that EST performed during CBD exploration at the time of enterolith removal has permitted the occurrence of ascending infection with resultant brown pigment stone formation.

Magnetic resonance imaging with a giant duodenal diverticulum. Duodenal diverticula mimicking cystic neoplasms of the pancreas: Diagnosing Lemmel’s syndrome could be challenging, but being aware lemel this condition is important to avoid mismanagement and it begins with identification syndome PAD.

A gastroduodenoscopy revealed a large periduodenal diverticulum in D2 Fig. When the enterolith was pushed into the diverticulum by cannulation catheter and contrast dye was injected Fig. Duodenal diverticula lemmfl pseudo-diverticula consisting of extraluminal sac-like out-pouchings of the duodenal mucosa which lack a muscularis layer [ 2 ].

Third, distal CBD or ampulla can be directly compressed mechanically by PAD that is usually filled with enterolith or bezoar 67. An yr-old woman presented to the emergency department on August 3, with nausea, vomiting, fever Published online May Contrast-enhanced Axial A and Coronal B CT Images of the Abdomen and Pelvis Post-Treatment Contrast-enhanced axial A and coronal B CT images of the abdomen and pelvis two weeks after conservative treatment demonstrate a small duodenal diverticulum with significantly improved surrounding inflammatory changes arrows.


J Hepatobiliary Pancreat Surg. Cureus is not responsible for the scientific accuracy or reliability of data or conclusions published herein. To date, there are few published cases, and the etiopathogenesis has not been completely established.

Endoscopy, 36pp. However, coronal reconstructed image shows that the stone black arrow is not located in the CBD but within the periampullary diverticulum that is filled with air and debris along with mid CBD stricture white arrow B.

Alexander Muacevic and John R Adler.

Lemmel syndrome | Radiology Reference Article |

A case of Mirizzi syndrome that was successfully treated by laparoscopic choledochoplasty using a gallbladder patch. We diagnosed him as having Lemmel syndrome. The remaining laboratory values were unremarkable.

In conclusion, Lemmel’s syndrome is a rare cause of obstructive jaundice that should be included in the differential diagnosis of biliary obstruction when PAD is present. To evaluate the cause of diffuse abdominal pain with liver enzyme elevation in a cholestatic pattern, abdominal CT scan was taken.