Lemmel’s Syndrome: A Rare Cause for Recurrent Cholangitis and Pancreatitis

A 65 year old female presented with the history of obstructive jaundice, recurrent cholangitis and pancreatitis. She was managed conservatively for 2 years in a local hospital. The patient was then referred to our centre. On evaluation, ultrasonography of abdomen showed dilated common bile duct. Contrast enhanced computed tomography of abdomen showed dilated common bile duct and duodenal diverticulum. Magnetic resonance cholangio pancreatography revealed a diverticulum in the second part of duodenum compressing the distal common bile duct. Subsequently we performed a side viewing duodenoscopy, which revealed diverticulum at second part of duodenum and diagnosed as Lemmel’s syndrome. Endoscopic biliary sphincterotomy and biliary stenting was performed. Later she improved well.