Mirizzi syndrome : A case report emphasizing safe management strategies and literature review

Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved..

INTRODUCTION AND IMPORTANCE: Mirizzi syndrome, a rare complication of cholelithiasis, involves gallstones causing common hepatic duct compression. It poses diagnostic challenges with nonspecific symptoms. Early recognition and surgical intervention are crucial, emphasizing a multidisciplinary approach for this complex condition with potential complications.

CASE REPORT: A 69-year-old woman presented with pruritus, jaundice, and a history of hepatic colics. Laboratory results showed no signs of inflammation but indicated cholestasis. Imaging suggested Mirizzi syndrome type 1, confirmed by MRI. The patient underwent surgery, revealing Mirizzi syndrome type II with the presence of a cholecystocholedochal fistula involving less than one-third of the circumference of the main bile duct. Subtotal cholecystectomy and suturing of the main bile duct onto a T-tube were performed, resulting in a favorable recovery and normalization of blood tests after 10 days.

CLINICAL DISCUSSION: Mirizzi syndrome, named after surgeon Pablo Luis Mirizzi, was first detailed in 1948. Clinical symptoms include jaundice, colic pain, and complications such as cholecystocholedochal fistula and gallstone ileus. Blood tests and imaging aid diagnosis. Surgical management targets obstruction relief and defect repair. Dissecting Calot's triangle carries risks. In complex cases, cholecysto-choledocus-duodenostomy may be considered.

CONCLUSION: Mirizzi syndrome, a rare but significant condition, demands careful clinical attention to prevent underdiagnosis. Timely and appropriate management, utilizing imaging tests alongside ERCP, is essential for optimal outcomes and complication prevention.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:116

Enthalten in:

International journal of surgery case reports - 116(2024) vom: 13. März, Seite 109297

Sprache:

Englisch

Beteiligte Personen:

Touati, Med Dheker [VerfasserIn]
Belhadj, Anis [VerfasserIn]
Ben Othmane, Mohamed Raouf [VerfasserIn]
Khefacha, Fahd [VerfasserIn]
Khabthani, Syrine [VerfasserIn]
Saidani, Ahmed [VerfasserIn]

Links:

Volltext

Themen:

Bile duct injury
Case Reports
Cholecystitis
Cholecystocholedochal fistula
Mesh
Mirizzi syndrome

Anmerkungen:

Date Revised 13.03.2024

published: Print-Electronic

Citation Status PubMed-not-MEDLINE

doi:

10.1016/j.ijscr.2024.109297

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM36814349X