Lemmel Syndrome as Rare Cause of Secondary Sclerosing Cholangitis: An Unusual Presentation and Literature Review

Abstract

Lemmel’s syndrome is a rare and misdiagnosed cause of obstructive jaundice, It corresponds to cholestatic disease secondary to compression of the main bile duct by a periampullary duodenal diverticulum with secondary dilation of the extra- and intra-hepatic bile ducts. Approximately 5% of duodenal diverticles can cause symptoms and 1% have complications, with colangitis being the most common. Lemmel syndrome is a type of intermittent obstructive jaundice without the presence of coledocolithiasis. Late diagnosis of this entity is common and may lead to unnecessary further investigations and therapeutic delay. There are no cases reports published associated with secondary sclerosing colangitis.