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CC BY-NC-ND 4.0 · Journal of Digestive Endoscopy 2022; 13(01): 050-052
DOI: 10.1055/s-0041-1739565
Case Report

A Novel Technique of Intradiverticular Papillary Canulation Aided by EVL Band Ligator in a Case of Lemmel's Syndrome

Shanmuganathan Subramanyam 
1   Department of Medical Gastroenterology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
,
Vatsal Bachkaniwala
1   Department of Medical Gastroenterology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
,
Chunduri V.V. Vikranth 
1   Department of Medical Gastroenterology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
,
P Ganesh
1   Department of Medical Gastroenterology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
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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


Publication History

Article published online:
18 January 2022

© 2022. Society of Gastrointestinal Endoscopy of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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