Lemmel's Syndrome, an unusual cause of abdominal pain and jaundice by impacted intradiverticular enterolith: Case report

Hyo Sung Kang, Jong Jin Hyun, Seung Young Kim, Sung Woo Jung, Ja Seol Koo, Hyung Joon Yim, Sang Woo Lee

    Research output: Contribution to journalArticlepeer-review

    12 Citations (Scopus)

    Abstract

    Duodenal diverticula are detected in up to 27% of patients undergoing upper gastrointestinal tract evaluation with periampullary diverticula (PAD) being the most common type. Although PAD usually do not cause symptoms, it can serve as a source of obstructive jaundice even when choledocholithiasis or tumor is not present. This duodenal diverticulum obstructive jaundice syndrome is called Lemmel's syndrome. An 81-yr-old woman came to the emergency room with obstructive jaundice and cholangitis. Abdominal CT scan revealed stony opacity on distal CBD with CBD dilatation. ERCP was performed to remove the stone. However, the stone was not located in the CBD but rather inside the PAD. After removal of the enterolith within the PAD, all her symptoms resolved. Recognition of this condition is important since misdiagnosis could lead to mismanagement and therapeutic delay. Lemmel's syndrome should always be included as one of the differential diagnosis of obstructive jaundice when PAD are present.

    Original languageEnglish
    Pages (from-to)874-878
    Number of pages5
    JournalJournal of Korean medical science
    Volume29
    Issue number6
    DOIs
    Publication statusPublished - 2014

    Keywords

    • Enterolith
    • Lemmel's syndrome
    • Periampullary diverticulitis

    ASJC Scopus subject areas

    • Medicine(all)

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