Mirizzi's syndrome

ICD-9	576.2
DiseasesDB	33254

Mirizzi's syndrome Microchapters
Home
Patient Information
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
Mirizzi's syndrome On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Mirizzi's syndrome All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Mirizzi's syndrome
CDC on Mirizzi's syndrome
Mirizzi's syndrome in the news
Blogs on Mirizzi's syndrome
Directions to Hospitals Treating Mirizzi's syndrome
Risk calculators and risk factors for Mirizzi's syndrome

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Pathophysiology

Multiple and large gallstones 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.

Features

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.

Diagnosis

CT scan or ultrasonography usually make the diagnosis. Often, ERCP is used to define the lesion anatomically prior to surgery.

Treatment

The treatment of choice is surgical excision of the gallbladder, and reconstruction of the common hepatic duct and common bile duct.

Eponym

It is named for Pablo Mirizzi.

References

Template:Gastroenterology

  Normal  0            false  false  false    EN-US  X-NONE  X-NONE                                       MicrosoftInternetExplorer4

Template:WikiDoc Sources