Mirizzi syndrome type IV associated with cholecystocolic fistula: A very rare condition - Report of a case

被引：12

作者：

Chatzoulis G. ^{[1
]}

Kaltsas A. ^{[1
]}

Danilidis L. ^{[2
]}

Dimitriou J. ^{[1
]}

Pachiadakis I. ^{[3
]}

机构：

[1] Department of Surgery

[2] Department of Surgery, St. Loukas Hospital Thessaloniki

[3] Department of Gastroenterology

来源：

BMC Surgery | / 7卷 / 1期

关键词：

Common Bile Duct; Bile Duct Injury; Hepatic Flexure; Fistulous Tract; Mirizzi Syndrome;

D O I：

10.1186/1471-2482-7-6

中图分类号：

学科分类号：

摘要：

Background. Mirizzi syndrome is a rare complication of prolonged cholelithiasis with presence of large, impacted gallstone into the Hartman's pouch, causing chronic extrinsic compression of common bile duct (CBD). Fistula formation between the CBD and the gallbladder may represent an outcome of that condition. According to Mirizzi's classification and Csendes's subclassification, Mirizzi syndrome type IV represents the most uncommon type (4%). Spontaneous biliary-enteric fistulas have also been rarely reported (1.2-5%) in a large series of cholecystectomies. Cholecystocolic fistula is the most infrequent biliary enteric fistula, causing significant morbidity and representing a diagnostic challenge. Case presentation. We describe a very rare, to our knowledge, combination of Mirizzi syndrome type IV and cholecystocolic fistula. A 52 year old male, presented to our clinic complaining of episodic diarrhea (monthly episodes lasting 16 days), high temperature (38°C-39°C), right upper quadrant pain without jaundice. The definitive diagnosis was made intraoperatively. Magnetic Resonance Imaging (MRI) and Endoscopic Retrograde Cholangiopancreatography (ERCP) demonstrated the presence of Mirizzi syndrome with cholecystocolic fistula formation. The patient was operated upon, and cholecystectomy, cholecystocolic fistula excision and Roux-en-Y biliary-enteric anastomosis were undertaken with excellent post-operative course. Conclusion. Appropriate biliary tree imaging with ERCP and MRI/MRCP is essential for the diagnosis of Mirizzi syndrome and its complications. Cholecystectomy, fistula excision and biliary-enteric anastomosis with Roux-en-Y loop appears to be the most appropriate surgical intervention in order to avoid damage to Calot's triangle anatomic elements. Particularly in our case, ERCP was a valuable diagnostic tool that Mirizzi syndrome type IV and cholecystocolic fistula. © 2007 Chatzoulis et al; licensee BioMed Central Ltd.

引用

共 35 条

[1]

Harrison N., Hashimoto L., Coexistence of Mirizzi Type II syndrome with a parapapillary choledochoduodenal fistula: A case report, Current Surgery, 59, pp. 416-417, (2002)

[2]

Contini S., Dalla Valle R., Zinicola R., Botta G.C., Undiagnosed Mirizzi's syndrome: A word of caution for laparoscopic surgeons-a report of three cases and review of the literature, J Laparoendosc Adv SurgTech a, 9, 2, pp. 197-203, (1999)

[3]

Swinnen L., Sainte T., Colonic gallstone ileus, J Belge Radiol, 77, pp. 272-274, (1994)

[4]

Waisberg J., Corona A., De Abreu I.W., Farah J.F., Lupinacci R.A., Goffi F.S., Benign obstruction of the common hepatic duct (Mirizzi syndrome): Diagnosis and operative management, Arq Gastroenterol, 42, pp. 13-18, (2005)

[5]

Redaelli C.A., Buchler M.W., Schilling M.K., Krahenbuhl L., Ruchti C., Blumgart L.H., Baer H.U., High coincidence of Mirizzi syndrome and gallbladder carcinoma, Surgery, 121, pp. 58-63, (1997)

[6]

Johnson L.W., Sehon J.K., Lee W.C., Zibari G.B., McDonald J.C., Mirizzi's syndrome: Experience from a multi-institutional review, Am Surg, 67, 1, pp. 11-14, (2001)

[7]

McSherry C.K., Ferstenberg H., Virshup M., The Mirizzi syndrome: Suggested classification and surgical therapy, Surg Gastroent, pp. 219-225, (1982)

[8]

Csendes A., Diaz J.C., Burdiles P., Maluenda F., Nava O., Mirizzi syndrome and cholecystobiliary fistula: A unifying classification, Br J Surg, 76, pp. 1139-1143, (1989)

[9]

Levowitz B.S., Spontaneous internal biliary fistulas, Ann Surg, 154, (1961)

[10]

Schafer M., Schneiter R., Krahenbuhl L., Incidence and management of Mirizzi syndrome during laparoscopic cholecystectomy, Surg Endosc, 17, pp. 1186-1190, (2003)

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