Lemmel Syndrome: A Rare Cause of Obstructive Jaundice

Dr. Hiral Pansuriya

Abstract: This article presents a unique case of Lemmel syndrome, a rare condition causing obstructive jaundice, in a 65 - year - old male. The patient exhibited symptoms of yellowish skin and sclera, accompanied by pruritus. Diagnostic tests revealed elevated bilirubin and liver enzymes, indicating an obstructive liver pattern. Crucially, CECT abdomen imaging identified a peri ampullary duodenal diverticulum obstructing the common bile duct, leading to biliary ductal dilatation. This condition, first described in 1934 by Lemmel, is characterized by biliary obstruction due to a peri ampullary duodenal diverticulum in the absence of choledocholithiasis or distal neoplasms. The patient was managed conservatively and monitored through follow - up, declining invasive intervention. The article underscores the importance of considering Lemmel syndrome in differential diagnosis for obstructive jaundice, especially when common causes are absent. It also emphasizes the utility of CT and MRI in diagnosing this condition, and discusses various treatment options, including surgical resection, endoscopic intervention, and conservative management, highlighting the complexity of surgical intervention in this region.

Keywords: Lemmel syndrome, obstructive jaundice, peri ampullary duodenal diverticulum, CECT abdomen, conservative management