SDMS CME Credit – Lemmel’s Syndrome With an Unusual Clinical Onset: Lessons Learned Based on This Patient Case

Abstract

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Authors: Renato Farina, MD, Corrado Inì, MD, Pietro Valerio Foti, PhD, Mattia D’Urso, MD, Claudia Motta, MD, Giuseppe Cocuzza, MD, Francesco Tiralongo, MD, Lorenzo Aliotta, MD, Agata Amaduri, MD, Davide Castiglione, MD, and Antonio Basile, PhD

Category: Abdominal [AB]

Credit: 0.50 SDMS CME Credit

Objectives: After studying the article, you should be able to:

Describe the pathophysiology and typical clinical features of Lemmel’s syndrome, including rare presentations.

Identify the role of imaging modalities in the diagnosis and management of Lemmel’s syndrome.

Explain the treatment options for Lemmel’s syndrome and how management is tailored based on symptom severity and patient condition.

What is the primary cause of biliary tract compression in Lemmel’s syndrome?

A. Periampullary duodenal diverticula (PAD)

B. Choledochal cysts

C. Gallbladder carcinoma

D. Cholangiocarcinoma

According to the case report in the article, what sonographic finding raised suspicion for Lemmel’s syndrome?

A. Thickened duodenal wall

B. Multiple gallstones

C. Enlarged pancreas

D. Dilated left intrahepatic bile ducts with no visible bile duct stones

According to the article, what finding on computed tomography (CT) helped confirm the diagnosis in the case report?

A. Fluid and air-filled periampullary diverticulum compressing the duodenum

B. Hepatic cyst compressing the bile duct

C. Obstructing gallstone in the common bile duct

D. Thickened bile duct wall with enhancement

What makes the diagnosis of Lemmel’s syndrome particularly challenging?

A. It only occurs in pediatric patients

B. It always mimics gallbladder cancer

C. It presents with nonspecific and intermittent symptoms

D. It does not appear on any imaging modality

Which of the following best describes the preferred treatment in elderly or frail patients with Lemmel’s syndrome and no jaundice?

A. Laparoscopic cholecystectomy

B. Biliary stenting with sphincterotomy

C. Open surgical diverticulectomy

D. Endoscopic emptying of the diverticulum

Footnotes

Access the SDMS CME test at: learn.sdms.org

Artificial Intelligence (AI) Disclosure: The SDMS utilized ChatGPT to assist in the development of this SDMS CME Test. Since AI has limitations such as potential biases, errors, and gaps in knowledge, all ChatGPT generated content is reviewed by a qualified subject matter expert to ensure that it is accurate and aligns with the learning objectives.