Presentation
Three episodes of jaundice with no cholelithiasis on ultrasound exam.
Patient Data
Age: 75 years
Gender: Female
From the case:
Lemmel syndrome
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/112508/annotated_viewer_json?iframe=true\u0026lang=us"}
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 a bile duct dilatation.