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Case Reports
. 2020 Apr 16;12(4):e7698.
doi: 10.7759/cureus.7698.

Lemmel's Syndrome: Usual Presentation of an Unusual Diagnosis

Michelle Bernshteyn  1 , Suman Rao  1 , Anuj Sharma  2 , Umair Masood  2 , Divey Manocha  2
Affiliations
Case Reports

Lemmel's Syndrome: Usual Presentation of an Unusual Diagnosis

Michelle Bernshteyn et al. Cureus. .

Abstract

Lemmel's syndrome causes obstructive jaundice in the absence of stones or tumors. The most common cause is the presence of periampullary diverticula which arise within 2-3 cm from the ampulla of Vater. Diverticula may be extramural or intramural. Despite current practice of obtaining imaging studies such as ultrasound, CT, and MRI, endoscopic retrograde cholangiopancreatography (ERCP) is the gold standard diagnostic test. Lemmel's syndrome should be considered when pancreaticobiliary disease is suspected. We present a case in which our patient presented with abdominal pain, fever, and transaminitis who underwent ERCP which was successful in diagnosis of Lemmel's syndrome and its treatment. Although rare, it is imperative for physicians to recognize this syndrome in order to deliver prompt care.

Keywords: diverticulum; endoscopy; lemmel.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Common bile duct measuring approximately 1.2 cm.
Figure 2
Figure 2. Subtle area of enhancement in the inferior portion of the right hepatic lobe.
Figure 3
Figure 3. Descending duodenal diverticulum measuring 2 cm.
See this image and copyright information in PMC

References

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