Parasar Kunal, John Aaron G, Mohan Shantam, Anand Utpal
Surgical Gastroenterology, All India Institute of Medical Sciences, Patna, IND.
Gastroenterology, All India Institute of Medical Sciences, Patna, IND.
Cureus. 2020 Aug 19;12(8):e9862. doi: 10.7759/cureus.9862.
Obstructive jaundice caused by periampullary duodenal diverticulum in absence of choledocholithiasis or tumor is known as Lemmel syndrome. This is a rare cause of obstructive jaundice. We report here a patient of blunt trauma abdomen who underwent emergency laparotomy whose sequelae was a controlled external biliary fistula which healed and led to obstructive jaundice. What appeared to be a clear cut diagnosis of benign biliary stricture or bilioma gave a surgical surprise on opening the pandoras box. The uniqueness of this case lies in its etiopathogenesis as well as the dearth of available literature related to post traumatic Lemmel syndrome. This case provides us with a insight into an easy to be overlooked cause of obstructive jaundice in the absence of duodenal diverticula.
在无胆总管结石或肿瘤的情况下，由壶腹周围十二指肠憩室引起的梗阻性黄疸被称为莱梅尔综合征。这是梗阻性黄疸的一种罕见病因。我们在此报告一名腹部钝性创伤患者，该患者接受了急诊剖腹手术，术后后遗症为可控性外胆道瘘，瘘口愈合后导致了梗阻性黄疸。看似明确诊断为良性胆管狭窄或胆汁瘤，然而打开“潘多拉魔盒”后却带来了手术意外。该病例的独特之处在于其病因发病机制以及与创伤后莱梅尔综合征相关的现有文献匮乏。此病例让我们深入了解到在无十二指肠憩室情况下，一种容易被忽视的梗阻性黄疸病因。
