Lemmel syndrome: An unexpected clinical presentation of obstructive jaundice - A case report.

INTRODUCTION AND IMPORTANCE

Lemmel syndrome is a rare condition causing obstructive jaundice, resulting from the compressive effect of a periampullary diverticulum (PD) on the common bile duct (CBD). This syndrome is unique as it occurs in the absence of gallstones or tumors. Accurate diagnosis is critical to prevent unnecessary interventions.

CASE PRESENTATION

We present the case of a 66-year-old man who developed generalized jaundice, significant weight loss, and epigastric pain. Diagnostic imaging, including ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI), revealed a periampullary duodenal diverticulum (PAD) compressing the distal CBD, leading to luminal dilatation without the presence of stones or malignancy. The patient was managed conservatively with antibiotics and supportive care, resulting in clinical improvement.

CLINICAL DISCUSSION

This case highlights the diagnostic challenges of Lemmel syndrome, a condition frequently misdiagnosed due to its rarity and nonspecific presentation. Imaging plays a pivotal role in distinguishing this syndrome from other causes of obstructive jaundice, such as malignancies or gallstones. Conservative management proved effective, underscoring the importance of non-invasive approaches.

CONCLUSION

Lemmel syndrome should be considered in patients with obstructive jaundice and periampullary diverticulum, particularly in the absence of stones or tumors. Accurate diagnosis is essential to avoid unnecessary surgical or invasive procedures, as conservative treatment can lead to favorable outcomes.