Lemmel syndrome

Case contributed by Utkarsh Kabra
Diagnosis almost certain

Presentation

Pancreatitis, ? biliary etiology.

Patient Data

Age: 75 years
Gender: Male
mri
This study is a stack
Axial T2
fat sat
This study is a stack
Axial
T2
This study is a stack
Coronal
T2
This study is a stack
Coronal
MRCP
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Info

Outpouching from 2nd part of the duodenum, causing compression of CBD, proximal upstream dilation and mild prominence of proximal intrahepatic biliary radicals. A rim of fluid is seen surrounding the lesion with a focus of air. 

The pancreas is heterogeneous in appearance with peripancreatic fat stranding, fluid, perinephric fat stranding and mild ascites.

Case Discussion

Outpouching from 2nd part of the duodenum, causing compression of CBD, proximal upstream dilation and mild prominence of proximal intrahepatic biliary radicals. A rim of fluid is seen surrounding the lesion with a focus of air; likely duodenal diverticulum with diverticulitis. 

The pancreas is heterogeneous in appearance with peripancreatic fat stranding, fluid, perinephric fat stranding and mild ascites consistent with acute pancreatitis.

The above findings are consistent with Lemmel syndrome.

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