Acute cholecystitis and difficult gall bladder have severe inflammation and anatomical deformities like Mirizzi syndrome
, empyema and gangrene.
(29) proposed that Mirizzi syndrome
was a result of chronic inflammation caused by adenomyomatosis.
The omentum and the transverse colon were adherent to the gallbladder, and a fistula formation was observed between the transverse colon and the gallbladder (Mirizzi syndrome
, type 5).
was firstly reported by Pablo Luis Mirizzi (1893-1964), one of the major biliary surgeons in the past century.
Laparoscopic resection of cholecystocolic fistula and subtotal cholecystectomy by tri-staple in a type V mirizzi syndrome
. Case Reports Hepatol.
is defined as common hepatic duct obstruction caused by extrinsic compression or inflammation from cystic duct or gallbladder neck stone burden.
Nine (5%) patients required conversion to an open cholecystectomy for various reasons: bile duct injury (n=1), inflamed GB with empyema and colonic injury (n=1), lateral tear of dilated cystic duct (n=1), Mirizzi syndrome
(n=3), adhesions from previous laparotomy (n=1), adhesions and small bowel injury (n=1), sealed GB perforation with adhesions (n=1).
We report the first case of Mirizzi syndrome
in a patient who presented with biliary obstruction caused by pure calcium carbonate stones.
[sup] The gallbladder wall may appear irregular and thickened, with adhesions to surrounding tissue, and fistulas may develop into adjacent organs, and in some cases, can cause Mirizzi syndrome
. [sup] Zhao et al .
Al-Kawas, "Complications of gallstone disease: mirizzi syndrome
, cholecystocholedochal fistula, and gallstone ileus," American Journal of Gastroenterology, vol.
With chronicity of inflammation caused by gallstone obstruction of the cystic duct or the gallbladder may fuse to the extrahepatic biliary tree, causing Mirizzi syndrome
, or fistulize into the intestinal tract, causing so-called gallstone ileus.
Complications of acute cholecystitis such as gangrenous cholecystitis and Mirizzi syndrome
can be diagnosed with MRCP.