E-mail this Article (login required)
E-mail the Author (login required)
Post a Comment (login required)
Lemmel’s Syndrome: A Rare Cause of Obstructive Jaundice Secondary to Periampullary Diverticulum
Babar Ahmad Khan, Sania Hanif Khan, Anuj Vikrant Sharma
European Journal of Case Reports in Internal Medicine - © EFIM


In 1934 Lemmel was the first to report the presence of juxtapapillary diverticula and hepatocholangiopancreatic disease, excluding cholelithiasis. Obstructive jaundice caused by periampullary duodenal diverticulum (PAD) in absence of choledocholithiasis or tumor is known as Lemmel syndrome. A patient with an extraluminal duodenal diverticulum presenting with obstructive jaundice and pancreatitis is presented in this case. Although initially managed conservatively, the patient had recurrence of symptoms after 2 months but then had successful surgical resection of the duodenal diverticulum.


Lemmel’s syndrome, juxtapapillary diverticula, periampullary duodenal diverticulum (PAD), choledocholithiasis, cholelithiasis, ERCP, MRCP, ampulla of Vater, pancreaticobiliary.

  1. Buse PE, Edmundowicz SA. Proximal common bile duct obstruction secondary to a periampullary duodenal diverticulum: successful treatment with endoscopic stenting. Gastrointest Endosc 1991;37:635-7.
  2. Kang HS, Hyun JJ, Kim SY, Jung SW, Koo JS, Yim HJ, et al. Lemmel's syndrome, an unusual cause of abdominal pain and jaundice by impacted intradiverticular enterolith: case report. J Korean Med Sci 2014;29:874-8.
  3. 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.
  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. Clin Res Hepatol Gastroenterol ;36:628-31.
  5. Tan NC, Ibrahim S, Chen CM, Tay KH. Periampullary diverticulum causing biliary stricture and obstruction. Singapore Med J 2005;46:250-1.

© EFIM Copyright 2016