Presentation
Jaundice, high levels of direct bilirubin.
Patient Data
Age: 60 years
Gender: Female
From the case:
Lemmel syndrome
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Mildly dilated intrahepatic and extrahepatic biliary ducts (CBD - 1.0cm). In the biliary system, stones or mass aren't seen. At the 2nd part of the duodenum, there is seen an air-filled outpouching (periampullary diverticulum), that compresses the distal CBD. The gallbladder is removed.
Case Discussion
Duodenal diverticula are found in 27% of patients undergoing upper gastrointestinal examination. Periampullary diverticula (PAD) is the most common type. Although PAD does not usually provoke symptoms, it can be a source of obstructive jaundice even without choledocholithiasis or tumor.