Korean Journal of Gastrointestinal Endoscopy 1993;13(1): 127-131.
담낭 담관 누공을 동반한 Mirizzi 증후군 1예 ( A Case of Mirizzi Syndrome with Cholecystocholedochal Fistula )
송동화, 문종호, 박찬욱, 최재동, 이준성, 이문성, 김진홍, 조성원, 심찬섭, 송영식 (Dong Hwa Song, Jong Ho Moon, Chan Uk Park, Jae Dong Choi, Jun Sung Lee, Moon Sung Lee, Jin Hong Kim, Sung Won Cho, Chan Sup Shim and Young Sik Song)
Abstract
Mirizzi syndrome is a so-called functional hepatic syndrome with obstruction of the common hepatic duct secondary to pressure from an impacted stone, either in the cystic duct or the neck of the gallbladder. Mirizzi syndrome is classified into two types based on endoscopic retrograde cholangio-pancreatographic findings. Type I involves external compression of the common hepatic duct by a large stone impacted in the cystic duct or Hartmann's pouch. In type II, a chole-cystocholedochal fistul is present, caused by a calculus which has eroded partly or completely into the common bile duct. Gallstone obstruction of the cystic duct with resulting repeated attacks of inflammation and pressure necrosis leads to the formation of cholecystocholedochal fistulas. We experienced a 70-year-old female patient with Mirizzi syndrome type II, who complained of abdominal discomfort. ERCP revealed multiple filling defects in contracted gallbladder, which compressed lateral wall of common hepatic duct. Peroral cholangioscopy revealed an impacted stone at the neck of the gallbladder with neighboring mucosal erosions. She was treated under the diagnosis of Mirzzi syndrome type II by endoscopic biliary drainage and surgical operation.
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