Mirizzi syndrome with a fistula at the confluence of the hepatic ducts

作者：Tsalis Kostas^*; Zacharakis Emmanouil; Kirou Ioanna E; Sapidis Nikolaos; Vagios Ioannis; Kalfadis Stavros; Betsis Dimitrios

来源：Medical Science Monitor, 2009, 15(3): CS54-CS57.

• Mirizzi syndrome
• jaundice
• hepatic ducts confluence
• Roux-en-Y hepaticojejunostomy

Background: A rare case of Mirizzi syndrome with atypical presentation is reported.
Case Report: An 81-year-old woman with a known history of cholelithiasis presented with epigastric discomfort and indigestion. Imaging investigations revealed Mirizzi syndrome, while a cholecystobiliary fistula at the junction of the hepatic ducts was recognized intraoperatively and treated successfully with cholecystectomy and Roux-en-Y hepaticojejunostomy. During two years' follow-up the patient remains free of biliary symptoms.
Conclusions: Diagnosis of Mirizzi syndrome requires a high degree of clinical suspicion, especially m cases without out obstructive jaundice. A fistula at the level of the confluence of the hepatic ducts is a rare topographic variant of the syndrome that may need a totally different surgical approach.

• 出版日期2009-3