A Retrospective Study of Lemmel's Syndrome: Single Centre 15-year Experience

Lemmels's syndrome is obstructive jaundice due to periampullary duodenal diverticula in the absence of a neoplasm or choledocholithiasis. The aim of this study is to present our 15-year experience on this rare pathology. Endoscopy, imaging, and histopathology records of all the patients with obstructive jaundice who were managed in surgical unit 3 in our institute between January 2010 and December 2024 were reviewed retrospectively. Patients who were found to have periampullary duodenal diverticula were included in this study. Descriptive statistics were used to summarize the data. Of 10 cases of Lemmel's syndrome, there were 4 male and 6 female patients. Contrast enhanced computed tomography was done in all the cases and confirmed the diagnosis. Upper gastrointestinal endoscopy was done in all the cases to rule out any other associated mucosal pathology of stomach or duodenum. Surgical intervention was done in 4 cases. Duodenal diverticula were detected in up to 27% of patients requiring upper gastrointestinal endoscopy and imaging studies; while they became symptomatic in only 1-2% of the cases and were causing complications in up to 5% of the cases. Before attributing periampullary diverticula as a cause of obstructive jaundice, it is important to rule out other benign as well as malignant pathologies causing obstructive jaundice.