Gallbladder perforation due to the obstructing periampullary duodenal diverticulum (Lemmel’s syndrome): a case report

Lemmel's syndrome is a rare condition characterized by obstructive jaundice due to the periampullary duodenal diverticulum in the absence of choledocholithiasis or tumors. Its infrequent occurrence and non-specific clinical presentation can make it difficult to distinguish from other conditions. We present a case of Lemmel's syndrome in a 63-year-old male who exhibited symptoms of abdominal pain in right hypochondrium, vomiting, and fever. Imaging studies (magnetic resonance cholangiopancreatogram, computed tomography scan, and endoscopy) revealed an oval-shaped duodenal outpouching, distended gallbladder, common bile duct dilatation, and surprising localised gallbladder perforation leading to the diagnosis. Surgical intervention, including cholecystectomy and choledochoduodenostomy, successfully relieved the symptoms and biliary obstruction.