一例合并胰胆管合流异常的Lemmel综合征成功治疗病例报告
A successfully treated case of Lemmel syndrome with pancreaticobiliary maljunction: A case report.
作者信息
Yanagaki Mitsuru, Shiba Hiroaki, Hagiwara Shin, Hoshino Masato, Sakuda Hitoshi, Furukawa Yoshiyuki, Yanaga Katsuhiko
机构信息
Department of Digestive Surgery, AOI Universal Hospital, 2-9-1, Tamachi, Kawasaki-ku, Kawasaki-city, Kanagawa, 210-0822, Japan.
Department of Hepato-Biliary-pancreatic Surgery, Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
出版信息
Int J Surg Case Rep. 2020;72:560-563. doi: 10.1016/j.ijscr.2020.06.080. Epub 2020 Jun 24.
BACKGROUND
Lemmel syndrome is a rare condition that leads to cholangitis and/or pancreatitis due to intraduodenal diverticulum. Surgery is considered for the treatment of severe or repeated symptoms in patients with this condition.
CASE PRESENTATION
An 81-year-old woman was admitted to our hospital, complaining of general fatigue, BT 38.8 degree, and right hypochondoralgia. Her hepatobiliary enzyme levels were elevated, and enhanced abdominal computed tomography revealed dilation of the common bile duct and intraduodenal diverticulum. After restarting oral intake, her symptoms were exacerbated. Endoscopic retrograde cholangio-pancreatography (ERCP) revealed pancreaticobiliary maljunction and parapapillary diverticulum. Under a diagnosis of Lemmel syndrome with pancreaticobiliary maljunction complicated by acute pancreatitis and cholangitis, we performed extrahepatic bile duct resection with cholecystectomy and papilloplasty. Her postoperative course was uneventful, and the patient was discharged 20 days after surgery. She remains well at 5 months after surgery.
CONCLUSION
We herein report a successfully diagnosed and treated case of Lemmel syndrome with pancreaticobiliary maljunction.
背景
莱梅尔综合征是一种罕见疾病，由十二指肠内憩室导致胆管炎和/或胰腺炎。对于患有这种疾病的患者，若出现严重或反复症状，可考虑手术治疗。
病例介绍
一名81岁女性因全身乏力、体温38.8度及右季肋部疼痛入院。她的肝胆酶水平升高，腹部增强计算机断层扫描显示胆总管扩张和十二指肠内憩室。重新开始经口进食后，她的症状加重。内镜逆行胰胆管造影（ERCP）显示胰胆管合流异常和乳头旁憩室。在诊断为莱梅尔综合征合并胰胆管合流异常并发急性胰腺炎和胆管炎后，我们进行了肝外胆管切除术、胆囊切除术和乳头成形术。她的术后病程顺利，术后20天出院。术后5个月她情况良好。
结论
我们在此报告一例成功诊断并治疗的合并胰胆管合流异常的莱梅尔综合征病例。
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