Mirizzi Syndrome with Cholecystobiliary Fistula: Observation of Development from Asymptomatic Cholecystolithiasis to Surgery
Despite a considerable number of reports of Mirizzi syndrome, none have described the process of its development from simple cholecystolithiasis. We report an extremely rare case of Mirizzi syndrome in which it was possible to observe the process of development of cholecystobiliary fistula from asym...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Case Reports in Radiology |
| Online Access: | http://dx.doi.org/10.1155/2020/2049525 |
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| author | Hiroyuki Sugo Yuuki Sekine Naoki Iwanaga Shigefumi Neshime Michio Machida |
| author_facet | Hiroyuki Sugo Yuuki Sekine Naoki Iwanaga Shigefumi Neshime Michio Machida |
| author_sort | Hiroyuki Sugo |
| collection | DOAJ |
| description | Despite a considerable number of reports of Mirizzi syndrome, none have described the process of its development from simple cholecystolithiasis. We report an extremely rare case of Mirizzi syndrome in which it was possible to observe the process of development of cholecystobiliary fistula from asymptomatic cholecystolithiasis until unavoidable surgical intervention 4 years later. A 68-year-old woman presented at our hospital with right upper quadrant pain. She had been diagnosed as having asymptomatic cholecystolithiasis 4 years previously. Diagnostic abdominal computed tomography (CT) had revealed a 1.9 cm radiopaque stone, and thereafter, the patient had been monitored by imaging alone. CT conducted 6 months before the present admission revealed that the gallbladder stone was compressing the common hepatic duct, although the patient remained asymptomatic. On admission, abdominal CT showed that the gallbladder stone was obstructing the common bile duct with dilatation of the intrahepatic duct. Endoscopic retrograde cholangiopancreatography revealed a round filling defect at the confluence of the common bile duct and the image of the cystic duct; therefore, the patient was categorized as having Mirizzi syndrome type III, according to the Csendes classification. Intraoperative findings revealed a cholecystobiliary fistula involving up to two-thirds of the circumference of the common bile duct. |
| format | Article |
| id | doaj-art-5d02f004517240a68e1ba777e97872f6 |
| institution | Kabale University |
| issn | 2090-6862 2090-6870 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Radiology |
| spelling | doaj-art-5d02f004517240a68e1ba777e97872f62025-02-03T00:59:43ZengWileyCase Reports in Radiology2090-68622090-68702020-01-01202010.1155/2020/20495252049525Mirizzi Syndrome with Cholecystobiliary Fistula: Observation of Development from Asymptomatic Cholecystolithiasis to SurgeryHiroyuki Sugo0Yuuki Sekine1Naoki Iwanaga2Shigefumi Neshime3Michio Machida4Department of General Surgery, Juntendo University Nerima Hospital, 3-1-10 Takanodai, Nerima-ku, Tokyo 177-8521, JapanDepartment of General Surgery, Juntendo University Nerima Hospital, 3-1-10 Takanodai, Nerima-ku, Tokyo 177-8521, JapanDepartment of General Surgery, Juntendo University Nerima Hospital, 3-1-10 Takanodai, Nerima-ku, Tokyo 177-8521, JapanDepartment of General Surgery, Juntendo University Nerima Hospital, 3-1-10 Takanodai, Nerima-ku, Tokyo 177-8521, JapanDepartment of General Surgery, Juntendo University Nerima Hospital, 3-1-10 Takanodai, Nerima-ku, Tokyo 177-8521, JapanDespite a considerable number of reports of Mirizzi syndrome, none have described the process of its development from simple cholecystolithiasis. We report an extremely rare case of Mirizzi syndrome in which it was possible to observe the process of development of cholecystobiliary fistula from asymptomatic cholecystolithiasis until unavoidable surgical intervention 4 years later. A 68-year-old woman presented at our hospital with right upper quadrant pain. She had been diagnosed as having asymptomatic cholecystolithiasis 4 years previously. Diagnostic abdominal computed tomography (CT) had revealed a 1.9 cm radiopaque stone, and thereafter, the patient had been monitored by imaging alone. CT conducted 6 months before the present admission revealed that the gallbladder stone was compressing the common hepatic duct, although the patient remained asymptomatic. On admission, abdominal CT showed that the gallbladder stone was obstructing the common bile duct with dilatation of the intrahepatic duct. Endoscopic retrograde cholangiopancreatography revealed a round filling defect at the confluence of the common bile duct and the image of the cystic duct; therefore, the patient was categorized as having Mirizzi syndrome type III, according to the Csendes classification. Intraoperative findings revealed a cholecystobiliary fistula involving up to two-thirds of the circumference of the common bile duct.http://dx.doi.org/10.1155/2020/2049525 |
| spellingShingle | Hiroyuki Sugo Yuuki Sekine Naoki Iwanaga Shigefumi Neshime Michio Machida Mirizzi Syndrome with Cholecystobiliary Fistula: Observation of Development from Asymptomatic Cholecystolithiasis to Surgery Case Reports in Radiology |
| title | Mirizzi Syndrome with Cholecystobiliary Fistula: Observation of Development from Asymptomatic Cholecystolithiasis to Surgery |
| title_full | Mirizzi Syndrome with Cholecystobiliary Fistula: Observation of Development from Asymptomatic Cholecystolithiasis to Surgery |
| title_fullStr | Mirizzi Syndrome with Cholecystobiliary Fistula: Observation of Development from Asymptomatic Cholecystolithiasis to Surgery |
| title_full_unstemmed | Mirizzi Syndrome with Cholecystobiliary Fistula: Observation of Development from Asymptomatic Cholecystolithiasis to Surgery |
| title_short | Mirizzi Syndrome with Cholecystobiliary Fistula: Observation of Development from Asymptomatic Cholecystolithiasis to Surgery |
| title_sort | mirizzi syndrome with cholecystobiliary fistula observation of development from asymptomatic cholecystolithiasis to surgery |
| url | http://dx.doi.org/10.1155/2020/2049525 |
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