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KMID : 0359019930130010127
Korean Journal of Gastrointestinal Endoscopy
1993 Volume.13 No. 1 p.127 ~ p.132
A Case of Mirizzi Syndrome with Cholecystocholedochal Fistula
송동화
문종호/박찬욱/최재동/이준성/이문성/김진홍/조성원/심찬섭
Abstract
Mirizzi synndrome is a so-called functional hepatic syndrome with obstruction of the common hepatic duct secondary to pressure from an impacted stone, either in the cystic duct or the neck of the gallbladder.
Mirizzi syndrome is classified into two types based on endoscopic retrograde cholangiopancreatographic findings. Type I involves external compression of the common hepatic duct or Hartmann's pouch. In type II, a cholecystocholedochal fistula is
present,
caused by a calculus which has eroded partly or completely into the common bile duct. Gallstone obstruction of the cystic duct with resulting repeated attacks of inflammation and pressure necrosis leads to the formation of cholecystocholedochal
fi?tulas.
We experienced a 70-year-old female patient with Mirizzi syndrome type II, who complained of abdominal discomfort. ERCP revealed multiplefilling defects in contracted gallbladder, which comprossed lateral wall of common hepatic duct. Peroral
cholangioscopy revealed an impacted stone at the neck of the gallbladder with neighboring mucosal erosions. She was treated under the diagnosis of Mirizzi syndrome type II by endoscopic biliary drainage and surgical operation.
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