Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Lemmel's syndrome causes obstructive jaundice in the absence of stones or tumors. The most common cause is the presence of periampullary diverticula which arise within 2-3 cm from the ampulla of Vater. Diverticula may be extramural or intramural. Despite current practice of obtaining imaging studies such as ultrasound, CT, and MRI, endoscopic retrograde cholangiopancreatography (ERCP) is the gold standard diagnostic test. Lemmel's syndrome should be considered when pancreaticobiliary disease is suspected. We present a case in which our patient presented with abdominal pain, fever, and transaminitis who underwent ERCP which was successful in diagnosis of Lemmel's syndrome and its treatment. Although rare, it is imperative for physicians to recognize this syndrome in order to deliver prompt care.
 ...
PMID:Lemmel's Syndrome: Usual Presentation of an Unusual Diagnosis. 3243 77

Lemmel's syndrome consists of obstructive jaundice due to compression of a periampular duodenal diverticulum in the absence of choledocholithiasis or tumour. Periampular duodenal diverticula are usually incidental findings, but they can be complicated. We present two cases. The first is a 79-year-old woman with hypertension and chronic kidney disease who starts with epigastric pain. Blood tests show cholestasis and a rise in bilirubin and pancreatic enzymes. Abdominal computed tomography with contrast confirms biliary dilation, parapapillary duodenal diverticulum and acute pancreatitis. Follow-up is decided. The second case is an 80-year-old man, without previous illness, with abdominal pain, fever and jaundice. Magnetic resonance cholangiopancreatography shows a 4 cm duodenal diverticulum displacing bile and pancreatic duct. ERCP is performed with the placement of a plastic biliary stent. The etiopathogenic theories of Lemmel syndrome are chronic ampullar inflammation, Oddi sphincter dysfunction due to the diverticulum or direct compression by diverticular content. The diagnosis of Lemmel syndrome is a challenge. It can be diagnosed by imaging tests, although the gold standard for diagnosis and treatment is ERCP.
 ...
PMID:Lemmel syndrome: an uncommon complication of periampular duodenal diverticulum. 3326 3