Mirizzi Syndrome Secondary to Impacted Stone in A Low Inserted Cystic Duct Variant: Case Report
International Surgery(2024)
摘要
Abstract Introduction. Cystic duct anatomical variations are encountered frequently during surgical procedures. In this report, a female patient underwent laparoscopic cholecystectomy for acute cholecystitis and developed symptoms of obstructive jaundice subsequently, which was diagnosed as low insertion of the cystic duct and an impacted stone that was causing common hepatic duct obstruction. Case report. A 42-year-old female presented to the emergency room complaining of persistent right upper quadrant pain that was radiating to the back. White blood count (WBC) was slightly elevated with normal liver function tests (LFTs). An abdominal ultrasound was performed and confirmed cholelithiasis with no signs of acute cholecystitis or biliary dilatation. The patient underwent laparoscopic cholecystectomy as an emergency procedure for persistent biliary colic. Eight days later, the patient returned to the emergency room with obstructive jaundice and continued right upper quadrant pain with elevated WBC and LFTs. Further tests were conducted, and the patient was found to have a long cystic duct with a low insertion variant to the common hepatic duct. An impacted stone was identified in the cystic duct, referred to as Mirizzi syndrome Type I. The patient underwent endoscopic retrograde cholangiopancreatography (ERCP) several times, but the common bile duct could not be cannulated. In the last ERCP session, SpyGlass and electrohydraulic lithotripsy were performed with a balloon sweep. Conclusion. This case demonstrates the importance of understanding Mirizzi syndrome and cystic duct variation to achieve optimal treatment, and careful assessment and investigation are essential for proper diagnosis. In experienced hands, Mirizzi syndrome secondary to an impacted cystic duct stone can be managed successfully with ERCP, electrohydraulic lithotripsy, and SpyGlass.
更多查看译文
AI 理解论文
溯源树
样例
![](https://originalfileserver.aminer.cn/sys/aminer/pubs/mrt_preview.jpeg)
生成溯源树,研究论文发展脉络
Chat Paper
正在生成论文摘要