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A giant duodenal diverticulum causing Lemmel syndrome
Roseanne Tobin1, Niamh Barry1, Niamh M Foley2
1School of Medicine, University College Cork, College Road, Cork, Ireland.
Journal of Surgical Case Reports
|October 24, 2018
Summary
A giant duodenal diverticulum caused obstructive jaundice in an elderly patient, a rare condition known as Lemmel syndrome. Prompt diagnosis is crucial to avoid unnecessary investigations and manage this pancreaticobiliary complication.
Area of Science:
- Gastroenterology
- Hepatology
- Radiology
Background:
- Periampullary duodenal diverticula are uncommon, but can lead to rare complications.
- Lemmel syndrome is a specific pancreaticobiliary complication characterized by obstructive jaundice.
Observation:
- An 80-year-old female presented with obstructive jaundice despite no overt icterus.
- Magnetic Resonance Cholangiopancreatography (MRCP) revealed an 8 cm giant periampullary duodenal diverticulum compressing the common bile duct.
- Gallbladder distension with calculi and biliary dilatation were noted.
Findings:
- The giant duodenal diverticulum was identified as the cause of common bile duct obstruction.
- The patient's presentation was consistent with Lemmel syndrome, defined by duodenal diverticulum-induced biliary obstruction.
- Laboratory results confirmed obstructive jaundice.
Implications:
- Early recognition of Lemmel syndrome is vital to prevent delayed diagnosis.
- This case highlights the importance of considering duodenal diverticula as a cause of biliary obstruction.
- Timely diagnosis can prevent unnecessary invasive procedures and guide appropriate management.
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