Presentation
Renal colic.
Patient Data

Periampullary duodenal diverticulum with associated moderate CBD and intrahepatic duct dilatation. Diffuse fatty replacement of the pancreas is noted.
Right ureteric calculus with moderate dilatation of proximal ureter and hydronephrosis. Bilateral lower calyceal calculi are also noted.
Vaginal ring pessary is noted.
Case Discussion
Lemmel syndrome is secondary to a diverticulum of the second part of the duodenum compressing the intrapancreatic part of the common bile duct (CBD) with resultant upstream dilatation of the extra- and intrahepatic bile ducts. Patients may present with recurrent episodes of jaundice, pancreatitis and/or cholangitis.