Azzam Ayman Z, Alsinan Tuqa A, Alrebeh Ghader A, Alhaider Tahirah, Alnaqaeb Lara J, Amin Tarek M
Department of General Surgery, Faculty of Medicine, Alexandria University, Alexandria, EGY.
Department of Surgical Oncology, Oncology Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU.
Cureus. 2021 Dec 1;13(12):e20093. doi: 10.7759/cureus.20093. eCollection 2021 Dec.
Lemmel syndrome is a rare cholestatic disease caused by a periampullary duodenal diverticulum (PAD) compressing the common bile duct (CBD) or pancreatic duct, which results in acute abdominal pain and/or obstructive jaundice in the absence of other pathology explaining the symptoms. It can be easily misdiagnosed unless carefully detected by abdominal ultrasound (US), barium studies, computed tomography (CT) scan, esophagogastroduodenoscopy (EGD), magnetic resonance cholangiopancreatography (MRCP), and endoscopic retrograde cholangiography (ERCP), which is also the treatment modality of choice. We herein report a case of a 62-year-old male presenting with prolonged hypochondrial pain. He was diagnosed with Lemmel syndrome after performing US, barium meal, CT scan, EGD, and MRCP that was managed successfully by ERCP with sphincterotomy and stent placement.
莱姆尔综合征是一种罕见的胆汁淤积性疾病,由壶腹周围十二指肠憩室(PAD)压迫胆总管(CBD)或胰管引起,在没有其他能解释症状的病理情况下,会导致急性腹痛和/或梗阻性黄疸。除非通过腹部超声(US)、钡剂造影、计算机断层扫描(CT)、食管胃十二指肠镜检查(EGD)、磁共振胰胆管造影(MRCP)和内镜逆行胰胆管造影(ERCP)仔细检测,否则很容易误诊,而ERCP也是首选的治疗方式。我们在此报告一例62岁男性,表现为长期季肋部疼痛。在进行了超声、钡餐、CT扫描、EGD和MRCP检查后,他被诊断为莱姆尔综合征,并通过ERCP行括约肌切开术和支架置入术成功治疗。