Case Report
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World J Radiol. Oct 28, 2010; 2(10): 410-413
Published online Oct 28, 2010. doi: 10.4329/wjr.v2.i10.410
Mirizzi syndrome type Va: A rare coexistence of double cholecysto-biliary and cholecysto-enteric fistulae
Pavlos Lampropoulos, Nikolaos Paschalidis, Athanasios Marinis, Spiros Rizos
Pavlos Lampropoulos, Nikolaos Paschalidis, Athanasios Marinis, Spiros Rizos, First Department of Surgery, Tzaneio General Hospital, Afentouli and Zanni STR, 18536, Piraeus, Greece
Author contributions: Lampropoulos P and Marinis A drafted the manuscript; Paschalidis P operated the patient; Rizos R and Paschalidis N reviewed the manuscript and provided the final approval.
Correspondence to: Pavlos Lampropoulos, MD, First Department of Surgery, Tzaneio General Hospital, Afentouli and Zanni STR, 18536, Piraeus, Greece. pav.lampropoulos@gmail.com
Telephone: +30-210-9949460 Fax: +30-210-4592491
Received: June 20, 2010
Revised: July 16, 2010
Accepted: July 23, 2010
Published online: October 28, 2010
Abstract

Mirizzi syndrome is a rare cause of intermittent obstructive jaundice, where an impacted stone in the cystic duct or Hartmann’s pouch mechanically obstructs the common bile duct (CBD). We report a rare case of double cholecysto-biliary and cholecysto-enteric fistulae, in a 75-year-old female patient, presenting with a right upper quadrant abdominal pain and intermittent obstructive jaundice. Endoscopic retrograde cholangiopancreatography suggested Mirizzi syndrome. Operative findings included erosions of the lateral wall of the CBD and the second portion of the duodenum due to impacted gallstones. The defects were reconstructed primarily and a Kehr tube was inserted. The patient had an uneventful postoperative course and was discharged on the 14th postoperative day.

Keywords: Mirizzi syndrome, Obstructive jaundice, Gallstone, Cholecysto-enteric fistula, Endoscopic retrograde cholangiopancreatography