Lemmel syndrome

Case contributed by Dr Aditya Shetty

Presentation

Epigastric pain and jaundice.

Patient Data

Age: 70
Gender: Female

CT findings:

  • outpouching of the second part of duodenum causing compression of the adjacent distal CBD with resultant upstream dilatation

T2W images in coronal plane reveals dilatation of the extra- and intrahepatic bile ducts.

Red arrow indicates the duodenal diverticulum

Yellow arrow indicates the site of compression on the distal CBD

Case Discussion

Case of Lemmel syndrome, one of the rare causes of obstructive jaundice. 

A careful examination is required to diagnose this condition. A small diverticulum could be missed. A thorough understanding of the biliary anatomy is required. An ideal method would be to trace the common bile duct to its distal opening to detect the cause of narrowing.

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