[A case of Lemmel's syndrome with serious jaundice exacerbated by eating]

An 86-year old woman rapidly developed serious jaundice (T-Bil 18.3 mg/dl 12.3 mg/dl). Her jaundice was exacerbated by eating, and improved by fasting. Abdominal CT showed a giant diverticulum in the second part of the duodenum and dilation of the proximal common bile duct. Endoscopic findings confirmed juxtapapillary duodenal diverticulum in contact with the distal common bile duct. MRCP revealed extrinsic compression of the distal common bile duct by the diverticulum. Lemmel's syndrome was diagnosed. Jaundice did not recur after surgery. We speculated that in this case the diverticulum filled by duodenal contents easily compressed the distal common bile duct after eating.