Open Access
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

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
,
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
› Author Affiliations
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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.



Publication History

Article published online:
18 January 2022

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