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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Association of periampullary duodenal diverticula with bile le,mel stones and with technical success of endoscopic retrograde cholangiopancreatography. She complained of nausea, reduced appetite, weight loss, weakness sgndrome reduced mobility. MR cholangiopancreatography of Mirizzi syndrome and Lemmel syndrome.

Eur J Radiol ; Open in a separate window. The relationship between juxtapapillary duodenal diverticula and disorders of the biliopancreatic system: Clin Res Hepatol Gastroenterol. Report of a case of duodenal diverticulum containing gallstones.

The remaining laboratory values were unremarkable.

MRCP and ERCP in Lemmel Syndrome

lemmmel Magnetic resonance cholangiopancreatography was performed, which revealed dilatation of the biliary tract as well as a large duodenal diverticulum with an air-fluid level in its interior that was displacing and compressing the main biliary tract, with no images suggestive of cholelithiasis or choledocholithiasis Figs.

Check for errors and try again. November Pages CiteScore measures average citations received per document published. Lmmel diagnosed him as having Lemmel syndrome. Three-dimensional reconstruction showing dilatation of the proximal common hepatic bile duct with distal narrowing due to extrinsic compression by a large duodenal diverticulum arrow.


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Lekmel Published work is licensed under a Creative Commons Attribution 4. Synonyms or Alternate Spellings: Biliary cannulation combined with endoscopic sphincterotomy EST was also performed to explore the CBD for other possible causes of obstructive jaundice but no stone, stricture or obstruction by tumor could be found.

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Other surgical options would include diverticulectomy or bilodigestive anastomosis. Change of characteristics after myocardial infarction and usefulness of cardiac computed tomography. Can’t read the image? Thank you for updating your details. After completion of enterolith removal, filling defect is no longer seen within the PAD C. The patient denied any abdominal pain, fever, chills, nausea, vomiting, melena, hematochezia, and hematemesis.

Enterolith, Lemmel’s Syndrome, Periampullary Diverticulitis.

An ultrasound of abdomen displayed distension of the gallbladder with a large volume of stones and sludge, as well as intra- and extra-hepatic biliary ductal dilatation. Case presentation A year-old previously healthy woman presented to lemmek emergency department without any significant past medical history. She denied any vomiting, abdominal pain, melena, haematochezia, haematemesis, fever, chills or altered bowel habit.

Second, PAD many cause dysfunction in the sphincter of Oddi 5. Clin Res Hepatol Gastroenterol. They are more frequently located in the second portion of the duodenum, close to the ampulla of Vater juxtapapillary due to the weakness of the wall in this area.

Juxtapapillary duodenal diverticula and pancreatobiliary disease. Report of a case of duodenal diverticulum containing gallstones. Subscribe to our Newsletter. First, diverticulitis or direct mechanical irritation of PAD may cause chronic inflammation of ampulla and lead to chronic fibrosis of papilla papillitis chronica fibrosa 4.


Jong Jin Hyun, MD. Rarely, obstructive jaundice can develop secondary to PAD without choledocholithiasis or tumour in the setting of Lemmel syndrome [ 5 ]. Support Center Support Center.

Impact of periampullary duodenal diverticula at endoscopic retrograde cholangiopancreatography: A case of Mirizzi syndrome that was successfully treated by laparoscopic choledochoplasty using a gallbladder patch. Surgery was consulted and decided immediate surgical intervention was not warranted. Find articles by Jong Jin Hyun.

Lemmel Syndrome Secondary to Duodenal Diverticulitis: A Case Report

Magnetic resonance cholangiopancreatography showing the diverticulum arrow medial to the duodenum D in axial views. To date, there pemmel few published cases, and the etiopathogenesis has not been completely established. Focal outpouching of the duodenum adjacent to the papilla in 2 nd part of the duodenum causing compression of the CBD.

These diverticula are pseudo-diverticula consisting of outpouchings of mucosa, which lack a muscularis layer. On axial CT scan, a high attenuated stone density with internal air black arrow is seen on distal common bile duct CBD A.

Using CT scan and MRCP, periampullary diverticula may appear as thin-walled cavitary lesions on the medial wall of the second portion eyndrome the duodenum.