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莱梅尔综合征:一个外科谜团。

Lemmel Syndrome: A Surgical Enigma.

作者信息

Ali Iqbal M, Shetty Saurav K, Shetty Varun

机构信息

Surgery, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.

出版信息

Cureus. 2024 Jul 29;16(7):e65620. doi: 10.7759/cureus.65620. eCollection 2024 Jul.

Abstract

A periampullary diverticulum (PAD) is the most common type of duodenal diverticula found in patients undergoing upper gastrointestinal tract assessments. Even while PAD typically does not manifest any symptoms, it can nevertheless be a source of obstructive jaundice in the absence of a tumor or choledocholithiasis, a condition known as Lemmel's syndrome. We report a case of a 60-year-old woman who presented with abdominal discomfort and multiple episodes of vomiting. After comprehensive clinical examination and investigations, a provisional diagnosis of Lemmel's syndrome was made, leading to initial conservative management for diverticulitis, followed by an exploratory procedure. This case underscores the importance of recognizing Lemmel's syndrome as a differential diagnosis for obstructive jaundice when duodenal diverticula are present, to prevent misdiagnosis and ensure timely, appropriate treatment.

摘要

壶腹周围憩室(PAD)是在上消化道评估患者中发现的最常见的十二指肠憩室类型。尽管PAD通常不表现出任何症状,但在没有肿瘤或胆总管结石的情况下,它仍可能是梗阻性黄疸的一个来源,这种情况被称为莱梅尔综合征。我们报告了一例60岁女性患者,她出现腹部不适和多次呕吐。经过全面的临床检查和调查,初步诊断为莱梅尔综合征,首先对憩室炎进行保守治疗,随后进行了探查手术。该病例强调了在存在十二指肠憩室时,认识到莱梅尔综合征作为梗阻性黄疸鉴别诊断的重要性,以防止误诊并确保及时、适当的治疗。

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