{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T13:36:47Z","timestamp":1770298607633,"version":"3.49.0"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T00:00:00Z","timestamp":1741737600000},"content-version":"vor","delay-in-days":11,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>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.<\/jats:p>","DOI":"10.1093\/jscr\/rjaf129","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T03:42:51Z","timestamp":1741750971000},"source":"Crossref","is-referenced-by-count":2,"title":["Gallbladder perforation due to the obstructing periampullary duodenal diverticulum (Lemmel\u2019s syndrome): a case report"],"prefix":"10.1093","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-9647-8240","authenticated-orcid":false,"given":"Shruti","family":"Sah","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal Surgery, Birat Medical College and Teaching Hospital (BMCTH) , Tankisinwari, Morang, Biratnagar 56613 ,","place":["Nepal"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nissant","family":"Subedi","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Birat Medical College and Teaching Hospital (BMCTH) , Tankisinwari, Morang, Biratnagar 56613 ,","place":["Nepal"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amit","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Birat Medical College and Teaching Hospital (BMCTH) , Tankisinwari, Morang, Biratnagar 56613 ,","place":["Nepal"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pradeep","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Birat Medical College and Teaching Hospital (BMCTH) , Tankisinwari, Morang, Biratnagar 56613 ,","place":["Nepal"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6904-7972","authenticated-orcid":false,"given":"Narendra","family":"Pandit","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Birat Medical College and Teaching Hospital (BMCTH) , Tankisinwari, Morang, Biratnagar 56613 ,","place":["Nepal"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,3,12]]},"reference":[{"key":"2025031203424036400_ref1","doi-asserted-by":"publisher","first-page":"1267436","DOI":"10.3389\/fsurg.2023.1267436","article-title":"Evaluation and management of symptomatic duodenal diverticula: a single-center retrospective analysis of 647 patients","volume":"10","author":"Ren","year":"2023","journal-title":"Front Surg"},{"key":"2025031203424036400_ref2","first-page":"83","article-title":"Diverticular disease: a review on pathophysiology and recent evidence","volume":"89","author":"Piscopo","year":"2020","journal-title":"Ulster Med J"},{"key":"2025031203424036400_ref3","doi-asserted-by":"publisher","first-page":"rjab593","DOI":"10.1093\/jscr\/rjab593","article-title":"Lemmel syndrome: an extraordinary cause of obstructive jaundice-a case 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report","volume":"13","author":"Azzam","year":"2021","journal-title":"Cureus"},{"key":"2025031203424036400_ref7","doi-asserted-by":"publisher","first-page":"e60097","DOI":"10.7759\/cureus.60097","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":"2025031203424036400_ref8","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1016\/j.jviscsurg.2013.04.006","article-title":"Management of complicated duodenal diverticula","volume":"150","author":"Oukachbi","year":"2013","journal-title":"J Visc Surg"},{"key":"2025031203424036400_ref9","doi-asserted-by":"publisher","first-page":"E1051","DOI":"10.1055\/a-2155-4535","article-title":"Totally endoscopic treatment of duodenal 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