Lemmel's Syndrome: A Rare Cause of Obstructive Jaundice/Cholangitis/Pancreatitis
Mandeep Kaur* and Chintamani
Safdarjang Hospital, India
Submission: February 10, 2017; Published: April 26, 2017
*Corresponding author: Mandeep Kaur, Safdarjang Hospital, Ring Road, Opposite AIIMS Hospital, Safdarjung West, Safdarjung Campus, Ansari Nagar East, New Delhi, Delhi 110029, India, Email: sandhu.mandeep02@googlemail.com
How to cite this article: Mandeep K, Chintamani. Lemmel's Syndrome: A Rare Cause of Obstructive Jaundice/Cholangitis/Pancreatitis. Curr Trends Clin Med Imaging. 2017; 1(3): 555565. DOI: 10.19080/CTCMI.2017.01.555565
Clinical Image
Lemmel’s syndrome, first described by Lemmel in 1934, refers to duodenal diverticulum of second part of duodenum compressing on the Common bile duct which may present as obstructive jaundice, cholangitis, pancreatitis, or intrahepatic/ cholangiolar abscess.
50 Years old lady presented to our unit with chief complaints of pain epigastric region and deranged liver profile. A clinical diagnosis of pancreatitis was made and the patient managed accordingly. Subsequently CECT abdomen (Figure 1 & 2] was done which showed diverticula of second part of duodenum compressing on the intrapancreatic portion of CBD, dilatation of suprapancreatic portion of CBD, cholangiolar abscess. Barium swallow (Figure 3] of the patient also showed diverticula of second part of duodenum. Side viewing endoscopy confirmed the diagnosis Lemmel’s syndrome [1,2].
ERCP and sphincterotomy relieved the patient of all the symptoms.
References
- Kang HS, Hyun JJ, Kim SY, Jung SW, Koo JS, et al. (2014) Lemmel’s Syndrome, an Unusual Cause of Abdominal Pain and Jaundice by Impacted Intradiverticular Enterolith: Case Report. Journal of Korean Medical Science 29(6): 874-878.
- Karayiannakis AJ, Bolanaki H, Courcoutsakis N, Kouklakis G, Moustafa E, et al. (2012) Common Bile Duct Obstruction Secondary to a Periampullary Diverticulum. Case Reports in Gastroenterology 6(2): 523-529.