A case of Lemmel syndrome cured with repeating endoscopic treatment

Taketsuka, Shojiro; Yamashita, Tatsuya; Tagaya, Nobumi

doi:10.11641/pde.88.1_164

Cited by 2 publications

(1 citation statement)

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“…This minimally invasive procedure involves sphincterotomy, which widens the opening of the sphincter of Oddi, allowing bile to flow more freely. In some instances, stenting of the bile duct may also be necessary to maintain patency and drainage [13][14][15][16][17][18]. Instances of endoscopic clipping of a duodenal diverticulum as a treatment for recurrent cholangitis due to biliary compression in Lemmel's syndrome have shown promising results [16].…”

Section: Discussionmentioning

confidence: 99%

Beyond the Usual Suspects: A Pictorial Case Report of Lemmel Syndrome Emphasizing the Role of Multimodality Imaging

Subramonian,

R K,

Raja

et al. 2024

Cureus

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Lemmel syndrome, characterized by biliary and pancreatic duct obstruction secondary to a periampullary duodenal diverticulum (PAD), remains a rare and often overlooked diagnosis. Although duodenal diverticula are found in approximately 23% of the population, only about 5% of these cases lead to complications such as obstructions. A new case of Lemmel syndrome is demonstrated in the article about a middle-aged woman with chronic epigastric pain and right upper abdominal quadrant initially misdiagnosed as cholelithiasis. The accuracy of diagnosis was made possible by multimodal imaging methods, such as ultrasound, magnetic resonance cholangiopancreatography (MRCP), and computed tomography (CT) with oral contrast when a diffuse common bile duct was compressed by a PAD. Additionally, it highlights the necessity of including Lemmel syndrome in cases where patients have dilated bile ducts without calculi or mass lesions while emphasizing advanced imaging techniques for the revelation of structural malformations that underlay these conditions. The endoscopic intervention was minimally invasive but effective in relieving symptoms through sphincterotomy followed by laparoscopic cholecystectomy and biliary stent placement, thus making a point of the need for multiple disciplinary approaches toward treatment rare phenomenon like this one. This case report not only sheds light on the diagnostic and therapeutic avenues for Lemmel syndrome but also serves as a valuable educational resource for healthcare professionals. It emphasizes the need for heightened clinical vigilance and the adept use of imaging modalities in cases of biliary obstruction with obscure etiology. By contributing to the growing knowledge of this rare condition, we aim to facilitate timely diagnosis and optimize patient outcomes.

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