Mirizzi syndrome with a fistula at the confluence of the hepatic ducts.

Autor:	Tsalis KG; 4th Surgical Department, Aristotle University of Thessaloniki, G. Papanikolaou General Hospital, Exohi, Thessaloniki, Greece. Ctsalis@med.auth.gr, Zacharakis E, Kirou IE, Sapidis N, Vagios I, Kalfadis S, Betsis D
Jazyk:	angličtina
Zdroj:	Medical science monitor : international medical journal of experimental and clinical research [Med Sci Monit] 2009 Mar; Vol. 15 (3), pp. CS54-7.
Abstrakt:	Background: A rare case of Mirizzi syndrome with atypical presentation is reported. Case Report: An 81-year-old woman with a known history of cholelithiasis presented with epigastric discomfort and indigestion. Imaging investigations revealed Mirizzi syndrome, while a cholecystobiliary fistula at the junction of the hepatic ducts was recognized intraoperatively and treated successfully with cholecystectomy and Roux-en-Y hepaticojejunostomy. During two years' follow-up the patient remains free of biliary symptoms. Conclusions: Diagnosis of Mirizzi syndrome requires a high degree of clinical suspicion, especially in cases without obstructive jaundice. A fistula at the level of the confluence of the hepatic ducts is a rare topographic variant of the syndrome that may need a totally different surgical approach.
Databáze:	MEDLINE
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