Abstract
Obstructive jaundice is a potentially life-threatening condition with multiple etiologies. Lemmel syndrome is a rare and intriguing cause of obstructive jaundice, most commonly associated with a periampullary duodenal diverticulum. This syndrome presents a diagnostic challenge because its features are often subtle and can mimic more common causes of biliary obstruction. We report a case of a 68-year-old patient who presented with acute abdominal pain, had a broad differential, and was ultimately diagnosed with Lemmel syndrome. This case emphasizes the importance of recognizing the syndrome, as its presentation can overlap with several other conditions.