Lemmel syndrome

Case contributed by Ammar Haouimi
Diagnosis probable

Presentation

Three episodes of jaundice with no cholelithiasis on ultrasound exam.

Patient Data

Age: 75 years
Gender: Female
ct
This study is a stack
Axial
non-contrast
This study is a stack
Axial C+ portal
venous phase
This study is a stack
Axial C+ Portal
- thin cuts
This study is a stack
Sagittal C+ portal
venous phase
This study is a stack
Coronal C+ portal
venous phase
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Info

The gallbladder is moderately distended with no gallstones seen. Mildly dilated intrahepatic biliary ducts and CBD (12 mm). An air-filled outpouching at the medial aspect of the 2nd part of the duodenum seems to compress the distal CBD. 

No distal CBD stone, ampullary or periampullary mass is seen.

Case Discussion

Lemmel syndrome is defined as obstructive jaundice due to a periampullary duodenal diverticulum compressing the intrapancreatic CBD and causing bile duct dilatation.

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