{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T15:48:28Z","timestamp":1772639308103,"version":"3.50.1"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,5,10]],"date-time":"2025-05-10T00:00:00Z","timestamp":1746835200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction and importance:<\/jats:title>\n                    <jats:p>Lemmel syndrome is a rare condition causing obstructive jaundice, resulting from the compressive effect of a periampullary diverticulum (PD) on the common bile duct (CBD).<\/jats:p>\n                    <jats:p>This syndrome is unique as it occurs in the absence of gallstones or tumors. Accurate diagnosis is critical to prevent unnecessary interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation:<\/jats:title>\n                    <jats:p>We present the case of a 66-year-old man who developed generalized jaundice, significant weight loss, and epigastric pain. Diagnostic imaging, including ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI), revealed a periampullary duodenal diverticulum (PAD) compressing the distal CBD, leading to luminal dilatation without the presence of stones or malignancy. The patient was managed conservatively with antibiotics and supportive care, resulting in clinical improvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical discussion:<\/jats:title>\n                    <jats:p>This case highlights the diagnostic challenges of Lemmel syndrome, a condition frequently misdiagnosed due to its rarity and nonspecific presentation. Imaging plays a pivotal role in distinguishing this syndrome from other causes of obstructive jaundice, such as malignancies or gallstones. Conservative management proved effective, underscoring the importance of non-invasive approaches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Lemmel syndrome should be considered in patients with obstructive jaundice and periampullary diverticulum, particularly in the absence of stones or tumors. Accurate diagnosis is essential to avoid unnecessary surgical or invasive procedures, as conservative treatment can lead to favorable outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2025.111430","type":"journal-article","created":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T11:53:52Z","timestamp":1747137232000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Lemmel syndrome: An unexpected clinical presentation of obstructive jaundice \u2013 A case report"],"prefix":"10.1097","volume":"131","author":[{"given":"Masome Aghaei","family":"Lasboo","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Guilan University of Medical Sciences, Rasht, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soroush Ahmadi","family":"Machiani","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Guilan University of Medical Sciences, Rasht, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fatemeh Askari","family":"Yazdian","sequence":"additional","affiliation":[{"name":"Student Research Committee, Rafsanjan University of Medical Sciences, Rafsanjan, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"issue":"3","key":"R1-110-20260304","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1159\/000528031","article-title":"Diagnosis and management of Lemmel syndrome: an unusual presentation and literature review","volume":"16","author":"Love","year":"2022","journal-title":"Case Rep. Gastroenterol"},{"key":"R2-110-20260304","doi-asserted-by":"crossref","DOI":"10.1177\/11795476211063321","article-title":"An unusual cause of biliary tract obstruction: lemmel syndrome","volume":"14","author":"Aourarh","year":"2021","journal-title":"Clin. Med. Insights. Case Rep"},{"issue":"5","key":"R3-110-20260304","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1097\/JS9.0000000000000373","article-title":"The SCARE 2023 guideline: updating consensus Surgical CAse REport (SCARE) guidelines","volume":"109","author":"Sohrabi","year":"2023","journal-title":"Int. J. Surg"},{"key":"R4-110-20260304","doi-asserted-by":"crossref","first-page":"18","DOI":"10.14260\/jemds.v13i1.541","article-title":"Lemmel syndrome-early diagnosis of rare disease presenting with commonest symptom","author":"Shrivastava","year":"2024","journal-title":"J. Evol. Med. Dent. Sci"},{"issue":"5","key":"R5-110-20260304","article-title":"Beyond the usual suspects: a pictorial case report of Lemmel syndrome emphasizing the role of multimodality imaging","volume":"16","author":"Subramonian","year":"2024","journal-title":"Cureus"},{"key":"R6-110-20260304","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijscr.2023.108198","article-title":"Periampullary diverticulitis (Lemmel's syndrome) misdiagnosed as pancreatic head tumor: a report of two cases","volume":"106","author":"Maloku","year":"2023","journal-title":"Int. J. Surg. Case Rep"},{"key":"R7-110-20260304","doi-asserted-by":"crossref","DOI":"10.25259\/JCIS_9_2023","article-title":"Lemmel syndrome, a rare cause of obstructive jaundice by periampullary duodenal diverticulum: case report and review of the literature","volume":"13","author":"Krisem","year":"2023","journal-title":"J. Clin. Imaging Sci"},{"issue":"10","key":"R8-110-20260304","doi-asserted-by":"crossref","DOI":"10.1093\/jscr\/rjy263","article-title":"A giant duodenal diverticulum causing Lemmel syndrome","volume":"2018","author":"Tobin","year":"2018","journal-title":"J. Surg. Case Rep"},{"issue":"1","key":"R9-110-20260304","doi-asserted-by":"crossref","DOI":"10.1093\/jscr\/rjab593","article-title":"Lemmel syndrome: an extraordinary cause of obstructive jaundice\u2014a case report","volume":"2022","author":"Goroztieta-Rosales","year":"2022","journal-title":"J. Surg. Case Rep"},{"issue":"04","key":"R10-110-20260304","doi-asserted-by":"crossref","first-page":"665","DOI":"10.47191\/ijmscrs\/v4-i04-14","article-title":"Lemmel syndrome as a cause of obstructive jaundice: case report","volume":"4","author":"Octavio","year":"2024","journal-title":"Int. J. Med. Sci. Clin. Res. Stud"},{"issue":"2","key":"R11-110-20260304","doi-asserted-by":"crossref","first-page":"164","DOI":"10.18203\/2349-3933.ijam20230069","article-title":"Lemmel syndrome: a rare condition causing cholangitis due to duodenal diverticulum","volume":"10","author":"Chanda","year":"2023","journal-title":"Int. J. Adv. Med"},{"issue":"4","key":"R12-110-20260304","article-title":"Lemmel's syndrome: usual presentation of an unusual diagnosis","volume":"12","author":"Michelle","year":"2020","journal-title":"Cureus"}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261225006169?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261225006169?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2025.111430","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T10:06:53Z","timestamp":1772618813000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2025.111430"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6]]},"references-count":12,"journal-issue":{"issue":"C","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.1016\/j.ijscr.2025.111430","relation":{},"ISSN":["2210-2612"],"issn-type":[{"value":"2210-2612","type":"print"}],"subject":[],"published":{"date-parts":[[2025,6]]},"assertion":[{"value":"2025-01-18","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-10","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}