Lemmel syndrome: presentation of a Case
Abstract
Background: the duodenum corresponds to the second location where the gastrointestinal diverticula are most frequently presented after the colon. Lemmel's syndrome, also known as intermittent obstructive jaundice, presence of duodenal diverticula near the papilla of Vater could favor the development of pancreatic biliary diseases.
Objective: to present the case of an older adult with jaundice in mucosa and intermittent skin associated with febrile episodes not quantified and pain in the right hypochondrium.
Case report: a 67-year-old female patient with an obstructive jaundice syndrome, without the presence of choledocholithiasis or other alteration of the biliary tree other than the presence of a duodenal diverticulum. For this symptomatology is referred to Gastroenterology consultation.
Conclusions: Lemmel's syndrome is a rare pathology that must be taken into account as a cause of obstructive jaundice.
DeCS: JAUNDICE, OBSTRUCTIVE/diagnosis; JAUNDICE, OBSTRUCTIVE /pathology; DIVERTICULUM, STOMACH; AMPULLA OF VATER; CASE REPORTS.
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References
1. Wang Y, Liu K, Yang J. A rare cause of obstructive jaundice. Clín Gastroenterol Hepatol. 2013;11(7):A31.
2. Musumba C, Britton E, Smart H. A man presenting with severe postprandial epigastric pain, jaundice, and pyrexia: more than the usual suspects? Gastroenterology. 2013;144(2):274-469.
3. Gómez Espín R, Sánchez Quiles I, Hallal H, Joaquín Plaza J. Lesión hepatocelular aguda tras exposición sucesiva a clozapina y olanzapina en un paciente con hepatitis crónica C. Gastroenterol Hepatol. 2010;33(2):150-2.
4. Rouet J, Gaujoux S, Ronot M, Palazzo M, Cauchy F, Vilgrain V, et al. Lemmel’s syndrome as a rare cause of obstructive jaundice. Clín Res Hepatol Gastroenterol. 2012;36(6):628-31.
5. Kang HS, Hyun JJ, Kim SY, Woo Jung S, SeolKoo J, Joon Yim H, et al. Lemmel’s syndrome, an unusual cause of abdominal pain and jaundice by impacted intradiverticularenterolith: case report. J Korean Med Sci. 2014;29:874-8.
6. Karayiannakis AJ, Bolanaki H, Courcoutsakis N, Kouklakis G, Moustafa E, Prassopoulos P, et al. Common bile duct obstruction secondary to a periampullary diverticulum. Case Rep Gastroenterol. 2012;6:523-9.
7. Beisani M, Espin F, Dopazo C, Quiroga S, Charco R. Therapeutic management of juxtapapillary duodenal diverticulum. Cir Esp. 2013;91(7):463-5.
8. Oukachbi N, Brouzes S. Management of complicated duodenal diverticula. J Visc Surg. 2013;150(3):173-9.
9. Bittle MM, Gunn ML, Gross J, Rohrmann CA. Imaging of duodenal diverticula and their complications. Curr Probl Diagn Radiol. 2012;41(1):20-9.
10. Gálvez García C, Alventosa E, González González C, de Armas Perdomo R, LLanos JM, Garrido Carrasco MS, et al. Ictericia obstructiva con nombre propio: síndrome de Lemmel [Internet]. Granada, España: SERAM; 2018 [citado 12 Ene 2019]. Disponible en: https://docplayer.es/76619128-Ictericia-obstructiva-con-nombre-propio-sindrome-de-lemmel.html
11. Tajima A, Kurata H. Elderly patient with Lemmel syndrome. JSM Gastroenterol Hepatol. 2014;2(1):1010.
12. Melo MDK, Sánchez SVM, Dávila JGÁ. Ictericia obstructiva secundaria a síndrome de Lemmel. Reporte de caso. Rev Mex Cir Endoscop. 2018;19(3):21-34.

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