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1.
Rev. colomb. cir ; 38(1): 145-153, 20221230. tab, fig
Artigo em Espanhol | LILACS | ID: biblio-1415990

RESUMO

Introducción. Aproximadamente el 5 % de los divertículos duodenales pueden causar síntomas y el 1 % presentar complicaciones, siendo la colangitis la más frecuente. El síndrome de Lemmel corresponde a un tipo de ictericia obstructiva intermitente, asociado a la presencia de divertículos periampulares y disfunción del esfínter de Oddi, sin presencia de coledocolitiasis. Método. Se realizó una revisión sistemática de la literatura en Pubmed, Google Académico y ProQuest, con los términos: síndrome de Lemmel, divertículo duodenal sintomático e ictericia obstructiva intermitente. Resultados. Se encontraron 38 casos, siendo España el país con mayor número, seguido de México, Japón y Colombia. No hay diferencias de distribución con respecto al género. El tratamiento más frecuentemente empleado fue la colangio pancreatografia retrógrada endoscópica. Conclusión. El síndrome de Lemmel es poco frecuente, sin un cuadro clínico especifico, con un incremento en los casos informados en los últimos años, posiblemente debido a la mejor disponibilidad de métodos diagnósticos. Es más frecuente en pacientes en la octava década de la vida y su tratamiento generalmente es endoscópico


Introduction. Approximately 5% of duodenal diverticula can cause symptoms and 1% have complications, cholangitis being the most common. Lemmel syndrome corresponds to a type of intermittent obstructive jaundice, associated with the presence of peri-ampullary diverticula and sphincter of Oddi dysfunction, without choledocholithiasis. Method. A systematic review of the literature was carried out in Pubmed, Google Scholar, ProQuest, with the terms: Lemmel syndrome, symptomatic duodenal diverticulum, and intermittent obstructive jaundice.Results. 38 cases were found, Spain being the country with the highest number, followed by Mexico, Japan and Colombia. There are no differences in distribution with respect to gender. The most frequently used treatment was endoscopic retrograde cholangiopancreatography.Conclusion. Lemmel syndrome is a rare disease, without a specific clinical presentation, with an increase in reported cases in recent years possibly due to the better availability of diagnostic methods. It is more frequent in patients in the eighth decade of life and its treatment is generally endoscopic


Assuntos
Humanos , Ductos Biliares , Icterícia , Colestase , Divertículo , Duodeno
2.
Rev. colomb. gastroenterol ; 34(1): 69-72, ene.-mar. 2019. graf
Artigo em Espanhol | LILACS | ID: biblio-1003839

RESUMO

Resumen La ictericia obstructiva es una causa frecuente de consulta en los servicios de urgencias. El síndrome de Lemmel se describe como un síndrome biliar obstructivo secundario a un divertículo duodenal perpipapilar en el que se han descartado otras causas de ictericia obstructiva. Se describe un caso de ictericia obstructiva en una paciente de 84 años, en la que se realiza resonancia magnética y endosonografía biliopancreática que descartan litiasis biliar; posteriormente, es llevada a colangiopancreatografía retrógrada endoscópica (CPRE), en la que se evidencia divertículo peripapilar sin coledocolitiasis, y se realiza papilotomía, luego de la cual la paciente presenta una evolución clínica favorable.


Abstract Obstructive jaundice is a frequent for patients to come to emergency services. Lemmel's syndrome is an obstructive biliary syndrome secondary to a papillary duodenal diverticulum for which other causes of obstructive jaundice have been ruled out. We describe a case of obstructive jaundice in an 84-year-old patient who underwent magnetic resonance imaging and biliopancreatic endosonography to rule out biliary lithiasis. Subsequently, the patient underwent ERCP where the papillary diverticulum was evident and without choledocholithiasis. A papillotomy was performed. Afterwards, the patient's clinical evolution was favorable.


Assuntos
Humanos , Feminino , Idoso de 80 Anos ou mais , Síndrome , Colangiopancreatografia Retrógrada Endoscópica , Icterícia Obstrutiva
3.
Chinese Journal of Medical Ultrasound (Electronic Edition) ; (12): 144-147, 2018.
Artigo em Chinês | WPRIM | ID: wpr-712066

RESUMO

Objective The aim of this study was to explore the value of ultrasound in the diagnosis of Lemmel syndrome. Methods Ultrasound images of 36 patients with Lemmel syndrome confirmed by ERCP or surgery were retrospectively analyzed, and the image′s feature of ultrasound was explored. Results The ultrasound feature of Lemmel syndrome was showed as cystic protuberance from lesser curvature of duodenum, and three types of ultrasound characteristics were found: hyperechogenicity of gas, solid-cystic echogenicity full filled with fluid and inhomogeneous echogenicity full filled with food residue. The presence of hyperechogenicity (24 cases), solid-cystic echogenicity (8 cases), inhomogeneous echogenicity (4 cases) were found in 36 patients with periampullary diverticulum, and the biggest diameter of periampullary diverticulum was 6 to 32 mm. All of the patients (36 cases) were with mechanical obstruction in the common bile duct, and 12 patients were found mild dilatation of the pancreatic duct. Conclusion Higher clinical application value of ultrasound has been found when ultrasound is used in the diagnosis of Lemmel syndrome.

4.
GEN ; 68(3): 108-111, sep. 2014. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-748447

RESUMO

La formación divertícular del tubo digestivo es una enfermedad frecuente, el duodeno constituye la segunda localización en frecuencia de los divertículos en el tubo digestivo, generalmente se observan entre los 50 y 65 años, pero pueden estar presentes en todas las edades y afectar a ambos géneros, con discreto predominio en las mujeres. Su sintomatología es vaga y ocurre en menos de 10% de los casos, pero cuando se presenta da síntomas y complicaciones como diverticulitis, obstrucción, perforación o incluso condiciones graves pancreatobiliares, como ictericia obstructiva, colangitis y coledocolitiasis. Presentamos el caso de paciente femenino que ingresa al IVSS Hospital Dr. Miguel Pérez Carreño con dolor abdominal, tinte ictérico en piel y mucosas, coluria y acolia, además de hipertermia no cuantificadas. Alteración del perfil colestásico. Ultrasonido abdominal: dilatación de vías biliares intra y extrahepáticas, Colecistectomizada. Colangioresonancia: 1.- Dilatación de vías biliares intra y extrahepáticas. 2.- Estenosis abrupta del colédoco “en punta de lápiz”. Ultrasonido endoscópico: 1.- Dilatación de vías biliares intra y extrahepáticas. 2.- Divertículo duodenal? Endoscopia digestiva superior: Divertículos (2) duodenales. En vista de mejoría clínica y paraclínica y con evidencia divertículos yuxtapapilares se plantea el diagnóstico de síndrome ictéricoobstructivo intermitente por relación con divertículos duodenales.


Diverticular formation of the digestive tract is a common disease, the duodenum is the second most common site of diverticula in the digestive tract, usually seen between 50 and 65, but may be present in all ages and affect both genders with slight predominance in women. Its symptoms are vague and occurs in less than 10% of cases, but when presented gives symptoms and complications such as diverticulitis, obstruction, perforation or even pancreabilliary serious conditions such as obstructive jaundice, cholangitis and choledocholithiasis. We report the case of a female patient admitted to IVSS Dr. Miguel Perez Carreño Hospital with abdominal pain, jaundiced skin and mucous membranes, and acolia coluria further increases thermal unquantified. Alteration of cholestatic profile. Abdominal ultrasound: dilatation of intra- and extrahepatic bile duct, cholecystectomy. Colangioresonancia: 1. Dilated intrahepatic and extrahepatic bile ducts. 2. abrupt stenosis of the common bile "pencil-point". Endoscopic Ultrasound: 1. Dilated intrahepatic and extrahepatic bile ducts. 2. duodenal diverticulum? Superior Digestive Endoscopy: Diverticula (2) Duodenal. In view of clinical and paraclinical improvement and evidence Juxtapapillary diverticula diagnosis of intermittent ictéricobstructivo syndrome arises by relation to duodenal diverticula.

5.
Journal of Korean Medical Science ; : 874-878, 2014.
Artigo em Inglês | WPRIM | ID: wpr-163312

RESUMO

Duodenal diverticula are detected in up to 27% of patients undergoing upper gastrointestinal tract evaluation with periampullary diverticula (PAD) being the most common type. Although PAD usually do not cause symptoms, it can serve as a source of obstructive jaundice even when choledocholithiasis or tumor is not present. This duodenal diverticulum obstructive jaundice syndrome is called Lemmel's syndrome. An 81-yr-old woman came to the emergency room with obstructive jaundice and cholangitis. Abdominal CT scan revealed stony opacity on distal CBD with CBD dilatation. ERCP was performed to remove the stone. However, the stone was not located in the CBD but rather inside the PAD. After removal of the enterolith within the PAD, all her symptoms resolved. Recognition of this condition is important since misdiagnosis could lead to mismanagement and therapeutic delay. Lemmel's syndrome should always be included as one of the differential diagnosis of obstructive jaundice when PAD are present.


Assuntos
Idoso de 80 Anos ou mais , Feminino , Humanos , Dor Abdominal , Colangiopancreatografia Retrógrada Endoscópica , Colangiopancreatografia por Ressonância Magnética , Colangite/complicações , Divertículo , Duodenopatias/complicações , Fluoroscopia , Cálculos Biliares/diagnóstico , Icterícia Obstrutiva/complicações , Tomografia Computadorizada por Raios X
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