Abstract
A duodenal periampullary diverticulum can cause changes in the local anatomy and pose
a challenge for the cannulation of the bile duct. Cannulation may be much more difficult
if the ampulla is located within the diverticula. We present the case of a 40-year-old
man who developed obstructive jaundice and cholangitis because of the duodenal diverticula
mechanically obstructing the common bile duct (Lemmel's syndrome). The papilla was
located entirely within the duodenal diverticula and was brought out after placing
endoscopic variceal ligation (EVL) bands. Biliary access and stenting could be done
easily, after exposing the papilla. There were no complications during the procedure
or the recovery period.
Keywords
intradiverticular papilla - Lemmel's syndrome - duodenal diverticulum
