INTERMITTENT OBSTRUCTIVE JAUNDICE DUE TO A DUODENAL DIVERTICULUM: LEMMEL’S SYNDROME INITIALLY MISSED ON CT BUT LATER EVINCED WITH MAGNETIC RESONANCE CHOLANGIOGRAPHY AND ENDOSCOPY
Bibliographic record
Abstract
ue to a mechanical obstruction of the common bile duct, Lemmel's syndrome arises when a duodenal diverticulum induces obstructive jaundice.Intermittent obstructive jaundice is a rare conditionreported in 2-7% of patients undergoing studies.Although the majority of the diverticula are asymptomatic when the symptoms are present, they usually consist of jaundice, abdominal pain, or acute cholangitis; these symptoms can be intermittent.The imaging methods in diagnosing Lemmel's syndrome are crucial; the CT scan and magnetic resonance cholangiography (MRC) revealed periampullary diverticula on the medial wall of the second portion of the duodenum.Treatment varies depending on the aetiology and underlying cause.However, diverticulectomy remains the standard of care.This report describes a 75-year-old male who attended the emergency department with jaundice, acute abdominal pain, and a weight loss history.Through laboratory studies and duodenal endoscopy, obstructive jaundice due to Lemmel's syndrome was evinced and received appropriate treatment.Lemmel's syndrome was initially missed in the CT evaluation but identified in the MRC and endoscopic view of duodenal endoscopy.Clinicians should always consider diverticulum as a possible cause of pancreatitis and obstructive jaundice.Readers will find an updated review of the literature.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".