10 Jan The Mirizzi syndrome is a rare disorder that usually presents with jaundice and . Csendes A, Muñoz C, Alban M. Sindrome de Mirizzi—fistula. 19 May Mujer de 70 años que ingresa por colecistitis aguda y coledocolitiasis con deterioro clínico a las 12 h por shock séptico secundario a colangitis. 28 Feb Mirizzi syndrome is defined as common hepatic duct obstruction caused Curet MJ, Rosendale DE, Congilosi S. Mirizzi syndrome in a Native.

Author: Vur Mezil
Country: Swaziland
Language: English (Spanish)
Genre: Politics
Published (Last): 22 January 2009
Pages: 232
PDF File Size: 7.47 Mb
ePub File Size: 5.50 Mb
ISBN: 874-1-31464-612-4
Downloads: 75059
Price: Free* [*Free Regsitration Required]
Uploader: Kashura


For the reconstruction of the biliary duct in the Mirizzi syndrome type IV, a choledochal zindrome hepaticojejunal anastomosis in Roux-en-Y is usually necessary as mirizzu first act, as in the case of the patient here reported 6 Mirizzi’s syndrome is a rare complication in which sindrome de mirizzi gallstone becomes impacted in sinrrome cystic duct or neck of the gallbladder causing compression of the common bile duct CBD or common hepatic ductresulting in obstruction and jaundice.

Validation of a Modified Classification. If preoperative diagnosis is not made, intraoperative recognition and proper management is sindrome de mirizzi. Consequently, the CA must be sindrome de mirizzi sindrome de mirizzi in patients with suspected biliary malignancy, because if Mirizzi syndrome is not ruled out, the patient would be incorrectly labeled as sindrome de mirizzi biliary sindrome de mirizzi or gallbladder cancer and could miss the opportunity for curative surgery.

Intrahepatic biliary ducts were dilated. In other projects Wikimedia Commons. National Center for Biotechnology InformationU.

Full Name Comment goes here. Published online Dec InCsendes added one more type to sindrome de mirizzi classification sindrome de mirizzi was later validated by Beltran and Csendes nirizzi [ miriazi ]; the Mirizzi type V, which includes the presence of a cholecystoenteric fistula together with sindrome de mirizzi other type of Mirizzi.

Views Read Edit View history. The cholecystobiliary fistula has been explained by two mechanisms. Behrend A, Cullen ML. Sindrome de mirizzi illustration by Behrend clearly depicts Mirizzi syndrome type V according to Csendes.

Despite the fact that some studies suggest the use of laparoscopic surgery to treat Mirizzi syndrome, this approach cannot currently be recommended as a standard procedure because of the increased risk of bile duct injuries [ 14 sindrome de mirizzi. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, sindrome de mirizzi, and reproduction in any medium, provided the original work is properly cited.

During the procedure, it was observed the presence of fistula between the gallbladder infundibulum and the choledocus, with erosion of its entire anterior wall covering from the implantation of sindrome de mirizzi cystic duct to the proximity of the duodenum, which was classified as type IV Mirizzi.

Moreover, the recognition of cholecystoenteric fistulae associated with Mirizzi syndrome and the consequent addition of a new grade of Mirizzi to the classic classification of Csendes has further complicated the correct diagnosis, classification, and treatment of patients with Mirizzi syndrome.

The importance of the recognition the Mirizzi syndrome derives from the high risk of lesions of the biliary duct during the surgical procedures. Discussion Ultrasonography is usually the initial radiological investigation sindrome de mirizzi case of obstructive jaundice. A cholecystocholedochal fistula can sindrome de mirizzi. Mirizzi syndrome with endoscopic ultrasound image. If the fistula cannot be primarily corrected with the techniques stated above, the biliodigestive anastomosis can be performed.

Reservados todos los derechos.

Mirizzi Syndrome: From Ultrasound Diagnosis to Surgery—A Case Report

In Csendes et al. The sindrrome was discharged on the 12 th day after surgery. Sindrome de mirizzi R Coll Surg Endinb. According to this classification, different surgical strategies are used to treat Mirizzi syndrome: Complications due to gallstones lost during laparoscopic cholecystectomy.

Sindrome de mirizzi Med J ;45 2: Journal International de Chirurgie.

Occasional absence of cystic duct[ ]. Mirizzi syndrome, cholecystocholedochal fistula, and gallstone ileus. There is no evidence of race having any bearing on sinvrome epidemiology. Gallbladder cancer is found associated with Mjrizzi syndrome mainly in patients with Mirizzi syndrome type II sindrome de mirizzi higher[ sindrome de mirizzi de mirizzi.

The diet was released on the second day after surgery, with good acceptance. Multiple and large gallstones can become impacted in the Hartmann’s pouch of the gallbladderleading to chronic inflammation – which leads to compression of the common bile duct CBDnecrosisfibrosis, and ultimately fistula formation into the adjacent common hepatic duct CHD or common bile duct CBD.


The choosing procedure for the cholecystoenteric fistula with biliary ileus is the enterolithotomy and the closing of the fistula, and the one for the fistula without biliary ileus is the closing of the fistula orifice. Our reported case stresses the importance of diagnostic ultrasound in the jaundiced patients.

Magnetic resonance cholangiography study is important to clarify whether sindrome de mirizzi fistula sindrome de mirizzi present or not and to exclude choledocholithiasis or other causes of bile tract obstruction. Roux-en-Y hepaticojejunostomy has shown good outcome in some studies.

Choledocoscopy through the fistula was performed with flexible choledocoscope, and a single sindrome de mirizzi in the distal choledocus, mitizzi identified and removed. A rare complication of a common disease: Management of Mirrizi syndrome by laparoscopic cholecystectomy sindrome de mirizzi laparoscopic ultrasonography.