PDF(Pubmed)
Abstract：
UNASSIGNED: 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.
METHODS: 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.
UNASSIGNED: 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.
CONCLUSIONS: 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.
METHODS: 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.
UNASSIGNED: 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.
CONCLUSIONS: 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.
摘要：
■Mirizzi综合征,胆石症的罕见并发症,涉及胆结石导致肝总管受压。它带来了非特异性症状的诊断挑战。早期识别和手术干预至关重要，强调多学科的方法，这种复杂的条件与潜在的并发症。
方法：一名69岁女性出现瘙痒，黄疸,还有肝绞痛病史.实验室结果显示无炎症迹象，但提示胆汁淤积。影像学提示Mirizzi综合征1型，经MRI证实。病人接受了手术,显示II型Mirizzi综合征，存在胆囊胆总管瘘，占不到主胆管周长的三分之一。进行了胆囊大部切除术和将主胆管缝合到T形管上，导致10天后血液检查的良好恢复和正常化。
■Mirizzi综合征，以外科医生PabloLuisMirizzi的名字命名,在1948年首次详细介绍。临床症状包括黄疸,绞痛,以及胆囊胆总管瘘和胆石性肠梗阻等并发症。血液检查和成像辅助诊断。手术治疗的目标是缓解梗阻和修复缺损。解剖卡洛的三角形有风险。在复杂的情况下,可以考虑胆囊-胆总管-十二指肠造口术。
结论：Mirizzi综合征，一种罕见但意义重大的疾病,需要仔细的临床注意，以防止诊断不足。及时和适当的管理，与ERCP一起使用成像测试，对于最佳结果和并发症预防至关重要。
方法：一名69岁女性出现瘙痒，黄疸,还有肝绞痛病史.实验室结果显示无炎症迹象，但提示胆汁淤积。影像学提示Mirizzi综合征1型，经MRI证实。病人接受了手术,显示II型Mirizzi综合征，存在胆囊胆总管瘘，占不到主胆管周长的三分之一。进行了胆囊大部切除术和将主胆管缝合到T形管上，导致10天后血液检查的良好恢复和正常化。
■Mirizzi综合征，以外科医生PabloLuisMirizzi的名字命名,在1948年首次详细介绍。临床症状包括黄疸,绞痛,以及胆囊胆总管瘘和胆石性肠梗阻等并发症。血液检查和成像辅助诊断。手术治疗的目标是缓解梗阻和修复缺损。解剖卡洛的三角形有风险。在复杂的情况下,可以考虑胆囊-胆总管-十二指肠造口术。
结论：Mirizzi综合征，一种罕见但意义重大的疾病,需要仔细的临床注意，以防止诊断不足。及时和适当的管理，与ERCP一起使用成像测试，对于最佳结果和并发症预防至关重要。
