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

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8 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 Jan 1

Fingerprint

Diverticulum
Jaundice
Abdominal Pain
Obstructive Jaundice
Choledocholithiasis
Upper Gastrointestinal Tract
Cholangitis
Endoscopic Retrograde Cholangiopancreatography
Diagnostic Errors
Hospital Emergency Service
Dilatation
Differential Diagnosis
Neoplasms

Keywords

  • Enterolith
  • Lemmel's syndrome
  • Periampullary diverticulitis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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title = "Lemmel's Syndrome, an unusual cause of abdominal pain and jaundice by impacted intradiverticular enterolith: Case report",
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.",
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author = "Kang, {Hyo Sung} and Hyun, {Jong Jin} and Kim, {Seung Young} and Jung, {Sung Woo} and Koo, {Ja Seol} and Yim, {Hyung Joon} and Lee, {Sang Woo}",
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T1 - Lemmel's Syndrome, an unusual cause of abdominal pain and jaundice by impacted intradiverticular enterolith

T2 - Case report

AU - Kang, Hyo Sung

AU - Hyun, Jong Jin

AU - Kim, Seung Young

AU - Jung, Sung Woo

AU - Koo, Ja Seol

AU - Yim, Hyung Joon

AU - Lee, Sang Woo

PY - 2014/1/1

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N2 - 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.

AB - 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.

KW - Enterolith

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KW - Periampullary diverticulitis

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