Volpe Alessio, Risi Chiara, Erra Maurizio, Cioffi Annamaria, Casella Vincenzo, Fenza Giacomo
Department of Radiology, L. Curto Hospital, Via Luigi Curto, 84035, Polla, Salerno, Italy.
Radiol Case Rep. 2021 Oct 4;16(12):3783-3786. doi: 10.1016/j.radcr.2021.08.068. eCollection 2021 Dec.
Lemmel's syndrome is a rare cause of obstructive jaundice in the absence of stones or tumors, commonly due to periampullary duodenal diverticulum (PAD). CT scan with the oral and intravenous administration of iodinated contrast media, was crucial to exclude the presence of stones or tumours, but esophagogastroduodenoscopy (EGD) confirms the diagnosis. We report a case of a 72 -year-old woman affected by Lemmel's syndrome secondary to a giant PAD, suffering from right upper abdominal quadrant pain and pancreaticobiliary disease. Subsequently we proceed to analyse the pathogenesis of PAD, and later to discuss pitfalls, tips and tricks useful to make a correct diagnosis, in order to achieve an accurate management.
莱姆尔综合征是在无结石或肿瘤情况下导致梗阻性黄疸的罕见原因，通常由壶腹周围十二指肠憩室（PAD）引起。口服和静脉注射碘化造影剂的CT扫描对于排除结石或肿瘤的存在至关重要，但食管胃十二指肠镜检查（EGD）可确诊。我们报告一例72岁女性患者，继发于巨大PAD的莱姆尔综合征，伴有右上腹象限疼痛和胰胆疾病。随后我们分析了PAD的发病机制，接着讨论了有助于做出正确诊断的陷阱、提示和技巧，以便实现准确的管理。
