Acute cholangitis in the context of Lemmel syndrome with signs of diverticulitis

Here, we present the case of a 51-year-old male with pain in the right hypochondrium, jaundice, fever, chills and septic shock. A computed tomography (CT) scan showed a juxtapapillary diverticulum with inflammatory changes, which caused bile duct ectasia and left biliary radicals. We considered this to be a septic shock of a biliary origin due to the cholangitis associated with Lemmel syndrome, with signs of juxtapapillary diverticulitis.