| Mirizzi's syndrome | |
|---|---|
| Classification and external resources | |
| ICD-9 | 576.2 |
| DiseasesDB | 33254 |
| eMedicine | radio/451 |
Mirizzi's syndrome is a rare cause of acquired jaundice. It is caused by chronic cholecystitis and large gallstones resulting in compression of the common hepatic duct.
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Occurs in approximately 0.1% of patients with gallstone disease[1] and 0.7-1.4% of patients undergoing cholecystectomy[2]
It affects males and females equally, but tends to affect older people more often. There is no evidence of race having any bearing on the epidemiology.
Multiple and large gallstones can reside chronically in the Hartmann's pouch of the gallbladder, causing inflammation, necrosis, scarring and ultimately fistula formation into the adjacent common hepatic duct (CHD). As a result, the CHD becomes obstructed by either scar or stone, resulting in jaundice. It can be divided into four types.
Type I - No fistula present
Types II-IV - Fistula present
Mirizzi syndrome has no consistent or unique clinical features that distinguish it from other more common forms of obstructive jaundice. Symptoms of recurrent cholangitis, jaundice, right upper quadrant pain, and elevated bilirubin and alkaline phosphatase may or may not be present. Acute presentations of the syndrome include pancreatitis or cholecystitis.
CT scan or ultrasonography usually make the diagnosis. Often, ERCP is used to define the lesion anatomically prior to surgery.
The treatment of choice is laparotomic surgical excision of the gallbladder, and reconstruction of the common hepatic duct and common bile duct.
It is named for Pablo Luis Mirizzi, an Argentinian physician.[3][4]
  | Mirizzi syndrome - Mirizzi Syndrome: eMedicine Radiology |
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