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[Mirizzi syndrome].

M Cabooter¹, S Sas, P Laukens

¹Algemeen Ziekenhuis Sint Jan. afd. Gastro-enterologie, Brugge.

Nederlands Tijdschrift Voor Geneeskunde

|April 7, 1990

Summary

Mirizzi's syndrome, caused by gallstones obstructing the common hepatic duct, presents diagnostic challenges. Surgical intervention is the primary treatment, with non-surgical drainage as a temporary measure.

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Area of Science:

Gastroenterology and Hepatobiliary Medicine

Background:

Mirizzi's syndrome involves common hepatic duct obstruction from impacted gallstones in the cystic duct or gallbladder.
Obstruction results from direct stone pressure or associated inflammatory infiltration.

Observation:

Six recent cases illustrate the diagnostic features of Mirizzi's syndrome.
Clinical presentation, sonography, and CT scans are often insufficient for accurate diagnosis.
Endoscopic retrograde cholangiography is typically diagnostic but can be confused with malignancies.

Findings:

Mirizzi's syndrome diagnosis can be challenging, often requiring advanced imaging.
Differential diagnosis includes gallbladder carcinoma, metastatic porta hepatis tumors, and cholangiocarcinoma.
Surgical management is the definitive treatment for Mirizzi's syndrome.

Implications:

Preoperative cholangiography is crucial for obstructive jaundice, even with cholelithiasis history.
Non-surgical biliary drainage aids surgery in cases with cholangitis.
Biliary stenting for suspected malignant obstruction necessitates exclusion of Mirizzi's syndrome.

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