PDF(Pubmed)
Abstract：
Diverticular disease is a major cause of hospitalizations, especially in the elderly. Although diverticulosis and its complications predominately affect the colon, the formation of diverticula in the small intestine, most commonly in the duodenum, is well characterized in the literature. Although small bowel diverticula are typically asymptomatic, and diagnosed incidentally, a complication of periampullary duodenal diverticulum is Lemmel syndrome. Lemmel syndrome is an extremely rare condition whereby periampullary duodenal diverticula, most commonly without diverticulitis, leads to obstruction of the common bile duct due to mass effect and associated complications including acute cholangitis and pancreatitis. Here, we present the first case, to our knowledge, of periampullary duodenal diverticulitis complicated by Lemmel syndrome with concomitant colonic diverticulitis with colovesical fistula. Our case and literature review emphasizes that Lemmel syndrome can present with or without suggestions of obstructive jaundice and can most often be managed conservatively if caught early, except in the setting of emergent complications.
摘要：
憩室疾病是住院的主要原因，尤其是老年人。尽管憩室病及其并发症主要影响结肠，小肠憩室的形成，最常见的是十二指肠，在文献中有很好的特点。尽管小肠憩室通常无症状，顺便诊断出来，十二指肠壶腹周围憩室的并发症是Lemmel综合征。Lemmel综合征是一种极其罕见的疾病，其中壶腹周围十二指肠憩室，最常见的是没有憩室炎，由于肿块效应和相关并发症，包括急性胆管炎和胰腺炎，导致胆总管阻塞。这里,我们提出第一个案例，根据我们的知识，十二指肠壶腹周围憩室炎并发Lemmel综合征合并结肠憩室炎合并结肠膀胱瘘。我们的病例和文献综述强调，Lemmel综合征可以存在或不存在阻塞性黄疸的建议，如果早期发现，通常可以保守治疗。除了在紧急并发症的背景下。
