The Current Approach to the Diagnosis and Classification of Mirizzi Syndrome

Klekowski, Jakub; Piekarska, Aleksandra; Góral, Marta; Kozula, Marta; Chabowski, Mariusz

doi:10.3390/diagnostics11091660

Cited by 22 publications

(27 citation statements)

References 46 publications

(141 reference statements)

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“…Mirizzi syndrome is an unusual complication of cholelithiasis encountered in 0.05-5.7% of patients [ 3 ]. It develops due to the impacted calculus in the infundibulum of GB, leading to extrinsic compression of the CBD with associated chronic inflammation; it most commonly presents with jaundice and cholangitis [ 1 , 3 ]. Over time, it may erode into the CBD, forming a cholecystobiliary fistula of various levels.…”

Section: Discussionmentioning

confidence: 99%

Mirizzi Syndrome With Bouveret Syndrome: A Rare Amalgam

Varshney¹,

Hussain²,

Selvakumar³

et al. 2022

Cureus

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Mirizzi and Bouveret syndromes are uncommon but important complications of calculous cholecystitis. Mirizzi syndrome commonly presents with jaundice due to extrinsic compression on the common bile duct by an impacted stone at the gall bladder infundibulum, whereas Bouveret syndrome presents with gastric outlet obstruction due to a large stone in the duodenum. Our case is a 65-year-old lady who presented with pain in the right upper abdomen associated with nausea and vomiting. Contrast-enhanced computed tomography and MRI of the abdomen were suggestive of calculus in the infundibulum of the gall bladder with compression over the common bile duct and a large stone in the first part of the duodenum. Upper gastrointestinal endoscopy confirmed the findings but could not retrieve the stone. Cholecystectomy with the retrieval of calculus from the infundibulum and duodenum was performed with the closure of the fistulous opening. The patient did well in the post-operative period and is doing well after nine months of follow-up. Chronic calculus cholecystitis can present in varied forms, and one should be aware of such rare complications and their management.

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Section: Discussionmentioning

confidence: 99%

Mirizzi Syndrome With Bouveret Syndrome: A Rare Amalgam

Varshney¹,

Hussain²,

Selvakumar³

et al. 2022

Cureus

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“…Its etiology is usually due to impaction of a gallstone at the level of the cystic duct or infundibulum associated with compression of the common hepatic duct, which can generate a cholecysto-choledocian fistula (the most common complication) [8]. The diagnosis of this syndrome can be very difficult [10], as it can be asymptomatic for a long period [9] or simulate other biliary diseases, such as gallbladder cancer itself [8,9,10], reported in this case.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, a standard treatment for Mirizzi syndrome is not yet well defined, due to the heterogeneity of clinical presentation and anatomical distortion, and therefore, surgical treatment must be planned after a careful assessment of the stage of the disease and biliary anatomy, with the objective of main to avoid any damage to the bile ducts. The approach can be open or laparoscopic, depending on the stage and experience of the assistant surgeon [6,9].…”

Section: Discussionmentioning

confidence: 99%

Gallbladder ADENOCARCINOMA COURSE WITH MIRIZZI SYNDROME: CASE REPORT

Macêdo¹,

Amorim²,

Ferreira³

et al. 2022

JHS

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Introduction:Gallbladder carcinoma (BVC) is the most common malignant neoplasm of the bile ducts, affecting more women in their sixties. It most commonly presents as an asymptomatic condition, but it can also present non-specific symptoms, or even mimic other biliary diseases, such as Mirizzi's syndrome (a biliary pathology characterized by obstructive jaundice). Tumor resection in early stages can be curative, but due to the lack of effective screening tests, its diagnosis usually occurs at a late stage, dramatically worsening the prognosis of the disease. In this case report, we approach a patient with gallbladder cancer associated with Mirizzi syndrome. Case report: Female patient, 59 years old, consulted at the surgery outpatient clinic of Santa Casa de Misericórdia de Fortaleza with complaints of jaundice associated with pruritus, fecal acholia and choluria. Initially, abdominal ultrasound was performed, which showed dilatation of the intrahepatic bile ducts, but without identification of obstructive factors. She was submitted to an resonance cholangiography which showed luminal narrowing at the level of the confluence of the hepatic ducts due to probable extrinsic compression of the gallbladder. Cholecystectomy was performed with partial hepatectomy sufficient to guarantee a surgical margin. During dissection of the hepatic pedicle, invasion of the left hepatic duct was observed, which was resected and a biliary anastomosis of the hepatic ducts with the jejunum was performed. Histopathological analysis of the gallbladder confirmed the diagnosis of adenocarcinoma. Conclusion: Concomitance of gallbladder adenocarcinoma with Mirizzi syndrome is rare. Detailed clinical history and imaging tests are sometimes not sufficient for diagnosis, requiring the association of histopathological methods to avoid underdiagnosis of this condition.

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“…ERCP is helpful for preoperative planning, as it gives insight into tumor invasion of the intrahepatic duct or common bile duct [7]. Ultimately, despite advances in cross-sectional imaging, Mirizzi syndrome and earlystage gallbladder tumors are often not routinely encountered radiologically, resulting in significant diagnostic difficulties [3].…”

Section: Discussionmentioning

confidence: 99%

“…Gallbladder adenocarcinoma is an uncommon malignancy that is considered of low incidence in North America. The most common risk factor for gallbladder adenocarcinoma is chronic inflammation such as a history of cholelithiasis, gallbladder polyps, and primary sclerosing cholangitis [3]. Gallbladder adenocarcinoma and Mirizzi syndrome have similar clinical presentations that often make it difficult to diagnose preoperatively, thus increasing complication rates during surgical management [4].…”

Section: Introductionmentioning

confidence: 99%

A Case of Gallbladder Adenocarcinoma Presenting as Mirizzi Syndrome in a Non-Jaundiced Patient With Recent Weight Loss

Gallego¹,

Fritz²,

Dominguez³

et al. 2022

Cureus

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There are many different types of gallbladder diseases, mainly resulting from inflammation. The long-term presence of an insult to the gallbladder leads to chronic inflammation, which is a nidus for complications such as Mirizzi syndrome and gallbladder cancer, both of which can become mimics of one another. Preoperative diagnosis of either gallbladder cancer or Mirizzi syndrome is often difficult, leading to late diagnosis and complicating the patient's treatment course. We report a case of a 65-year-old male who presented with abdominal pain and significant weight loss, with no physical evidence of jaundice and normal liver function. This was initially diagnosed as acute cholecystitis and Mirizzi syndrome before being diagnosed as gallbladder adenocarcinoma on final histology.

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The Current Approach to the Diagnosis and Classification of Mirizzi Syndrome

Cited by 22 publications

References 46 publications

Mirizzi Syndrome With Bouveret Syndrome: A Rare Amalgam

Mirizzi Syndrome With Bouveret Syndrome: A Rare Amalgam

Gallbladder ADENOCARCINOMA COURSE WITH MIRIZZI SYNDROME: CASE REPORT

A Case of Gallbladder Adenocarcinoma Presenting as Mirizzi Syndrome in a Non-Jaundiced Patient With Recent Weight Loss

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