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J Int Med Res. 2018 Nov;46(11):4806-4812. doi: 10.1177/0300060518797246. Epub 2018 Sep 23.

Mirizzi syndrome complicated by common hepatic duct fistula and left hepatic atrophy: a case report.

Author information

1
1 Department of Hepatobiliary, Pancreatic and Splenic Surgery, The Affiliated Hospital of Inner Mongolia Medical University, Huhhot, China PR.
2
2 Key Laboratory of Molecular Pathology, Inner Mongolia Medical University, Huhhot, China PR.

Abstract

BACKGROUND:

Mirizzi syndrome is a rare complication of chronic cholecystitis, usually caused by gallstones impacted in the cystic duct or the neck of the gallbladder. Mirizzi syndrome results in compression of the hepatic duct or fistula formation between the gallbladder and common bile duct (or hepatic duct, right hepatic duct, or even mutative right posterior hepatic duct). Clinical features include abdominal pain, fever, and obstructive jaundice. Severe inflammation and adhesion at Calot's triangle are potentially very dangerous for patients with Mirizzi syndrome undergoing cholecystectomy. Case presentation: We report the case of a 68-year-old Asian woman who presented with abdominal pain and jaundice. She had a medical history of gallstones, but no fever. Magnetic resonance cholangiopancreatography revealed cholecystitis, cholelithiasis, common hepatic duct stones, and ascites. Findings at surgery included a porcelainized, atrophic gallbladder that was full of gallstones, fistula formation between the gallbladder and common hepatic duct, and left hepatic atrophy. The prominent feature was the left hepatic atrophy, but stones were not visible pre-operatively in the left liver by radiologic examination.

CONCLUSIONS:

This patient exhibited what can be considered a special type II of Mirizzi syndrome with a fistula of the common hepatic duct as well as left hepatic atrophy.

KEYWORDS:

Mirizzi syndrome; chronic cholecystitis; common hepatic duct fistula; gallstone impaction; left hemihepatectomy; left hepatic atrophy

PMID:
30246584
PMCID:
PMC6259394
DOI:
10.1177/0300060518797246
[Indexed for MEDLINE]
Free PMC Article

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