Síndrome de Lemmel: relatos de casos

Abstract

Introduction: Lemmel’s syndrome is a rare cause of obstructive jaundice secondary to a periampullary duodenal diverticulum, which compresses the common bile duct. This compression results in dilation of intrahepatic and extrahepatic bile ducts in the absence of choledocholithiasis or other obstructive causes. Case report: We present two elderly patients with cholestasis indicated by obstructive jaundice, diagnosed with Lemmel syndrome by upper gastrointestinal endoscopy, which showed duodenal diverticula. The patients underwent surgical treatment with choledocoduodenostomy due to their advanced age, primary choledochal calculi and significant dilatation of the choledochal. They have presented a favorable evolution in the postoperative period. Conclusion: Lemmel syndrome is a condition that should be considered a differential diagnosis in elderly patients with cholestasis. It is essential to order imaging exams such as cholangioresonance and contrast computed tomography, and in the suspicion of a duodenal diverticulum, an endoscopy with a lateral view may confirm the diagnosis. There is no formal treatment for patients with Lemmel syndrome. In both cases, we performed surgical treatment