Lemmel syndrome

Case contributed by Ahmed A. Khawwam


Obstructive jaundice

Patient Data

Age: 70 years
Gender: Female

The common bile duct is dilated in its entire length. An air-filled outpouching from the second part of the duodenum exerts pressure on the distal end of the CBD.

No visible periampullary mass.

Incidental finding of small hemangioma in segment VIII of the liver.

Annotated image

Annotated image showing the close relationship of the duodenal diverticulum with the distal end of common bile duct (CBD).

Case Discussion

Lemmel syndrome is a rare cause of obstructive jaundice secondary to periampullary duodenal diverticulum causing pressure effect on distal common bile duct.  

Diagnosis confirmed by ERCP which revealed a large periampullary diverticulum 

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