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{{Infobox_Disease
|Name= 
|Image=
|Caption=
|DiseasesDB=33254
|ICD10=
|ICD9={{ICD9|576.2}}
|ICDO=
|OMIM=
|MedlinePlus=
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{{Mirizzi's syndrome}}
{{Mirizzi's syndrome}}
{{CMG}}; {{AE}} [[User:Tayebah Chaudhry|Tayebah Chaudhry]][mailto:dr.thch@yahoo.com]


{{CMG}}
==[[Mirizzi's syndrome overview|Overview]]==


==Overview==
==[[Mirizzi's syndrome historical perspective|Historical Perspective]]==
'''Mirizzi's syndrome''' is a rare cause of acquired [[jaundice]]. It is caused by chronic [[cholecystitis]] and large [[gallstone]]s resulting in stenosis of the [[common hepatic duct]].


==Epidemiology==
==[[Mirizzi's syndrome classification|Classification]]==
Occurs in approximately 0.1% of patients with [[gallstone]] disease<ref name="hazzan1999">{{cite journal
|last=Hazzan
|first=D
|coauthors=D Golijanin, P Reissman, SN Adler, E Shiloni
|year=1999
|month=06
|title=Combined endoscopic and surgical management of Mirizzi syndrome
|journal=Surgical Endoscopy
|volume=13
|issue=6
|pages=618–20
|pmid=10347304
|accessdate=2007-12-09}}</ref> and 0.7-1.4% of patients undergoing [[cholecystectomy]]<!--this should probably be Pemberton 1997, but I don't have the subscriptions--><ref name="ross2006">{{cite web
|url=http://www.emedicine.com/radio/topic451.htm
|title=Mirizzi syndrome
|accessdate=2007-12-09
|last=Ross
|first=Jeffrey W
|coauthors=Gary S Sudakoff, Gregory B Snyder, Neela Lamki (editor), Bernard D Coombs (editor), Abraham H Dachman (editor), Robert M Krasny (editor),  John Karani (editor)
|date=2006-12-29
|work=[[eMedicine]]
|publisher=[[WebMD]]}}</ref>


It affects males and females equally, but tends to affect older people more often. There is no evidence of race having any bearing on the epidemiology.
==[[Mirizzi's syndrome pathophysiology|Pathophysiology]]==


==Pathophysiology==
==[[Mirizzi's syndrome causes|Causes]]==
Multiple and large [[gallstone]]s can reside chronically in the [[Hartmann's pouch]] of the [[gallbladder]], causing [[inflammation]], [[necrosis]], scarring and ultimately [[fistula]] formation into the adjacent common bile duct (CBD). As a result, the CBD becomes obstructed by either scar or stone, resulting in [[jaundice]]. It can be divided into four types. Type I does not involve a fistula at all. Type II- IV involve fistulas of different sizes.


Type II is classified as a fistula of <33%of the CBD width, Type III Mirizzi Syndrome involves a fistula between 33% and 66% of the CBD width, and Type IV involves a fistula of greater than 66% of the CBD width.
==[[Mirizzi's syndrome differential diagnosis|Differentiating Mirizzi's syndrome from Other Diseases]]==


==Features==
==[[Mirizzi's syndrome epidemiology and demographics|Epidemiology and Demographics]]==
Mirizzi syndrome has no consistent or unique clinical features that distinguish it from other more common forms of obstructive jaundice. Symptoms of recurrent cholangitis, jaundice, right upper quadrant pain, and elevated [[bilirubin]] and [[alkaline phosphatase]] may or may not be present. Acute presentations of the syndrome include [[pancreatitis]] or [[cholecystitis]].
 
==[[Mirizzi's syndrome risk factors|Risk Factors]]==
 
==[[Mirizzi's syndrome screening|Screening]]==
Screening is currently not done for Mirizzi syndrome.
 
==[[Mirizzi's syndrome natural history, complications and prognosis|Natural History, Complications and Prognosis]]==


==Diagnosis==
==Diagnosis==
[[CT scan]] or [[ultrasonography]] usually make the diagnosis. Often, [[ERCP]] is used to define the lesion anatomically prior to surgery.
[[Mirizzi's syndrome history and symptoms|History and Symptoms]] | [[Mirizzi's syndrome physical examination|Physical Examination]] | [[Mirizzi's syndrome laboratory findings|Laboratory Findings]] | [[Mirizzi's syndrome x ray|X Ray]] | [[Mirizzi's syndrome CT|CT]] | [[Mirizzi's syndrome MRI|MRI]] | [[Mirizzi's syndrome ultrasound|Ultrasound]] | [[Mirizzi's syndrome other imaging findings|Other Imaging Findings]] | [[Mirizzi's syndrome other diagnostic studies|Other Diagnostic Studies]]


==Treatment==
==Treatment==
The treatment of choice is surgical excision of the gallbladder, and reconstruction of the common hepatic duct and common bile duct.
[[Mirizzi's syndrome medical therapy|Medical Therapy]] | [[Mirizzi's syndrome surgery|Surgery]] | [[Mirizzi's syndrome primary prevention|Primary Prevention]] | [[Mirizzi's syndrome secondary prevention|Secondary Prevention]] | [[Mirizzi's syndrome cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Mirizzi's syndrome future or investigational therapies|Future or Investigational Therapies]]
 
==Eponym==
It is named for Pablo Mirizzi.<ref>{{WhoNamedIt|synd|3587}}</ref><ref>Mirizzi PL: Syndrome del conducto hepatico. J Int de Chir 1948; 8: 731-77</ref>


==References==
==Case Studies==
{{Reflist|2}}
[[Mirizzi's syndrome case study one|Case #1]]




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[[Category:Gastroenterology]]
[[Category:Gastroenterology]]
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[[Category:Mature chapter]]
[[Category:Hepatology]]
[[Category:Hepatology]]


Latest revision as of 05:11, 7 August 2020

Mirizzi's syndrome Microchapters

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Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Mirizzi's syndrome from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Tayebah Chaudhry[2]

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Mirizzi's syndrome from Other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Screening is currently not done for Mirizzi syndrome.

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | X Ray | CT | MRI | Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1


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