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[A patient with a possible Mirizzi's syndrome].
[carcinoma of the gallbladder]
Mirizzi
's
syndrome
is
a
rare
cause
of
jaundice
.
The
syndrome
refers
to
common
hepatic
duct
obstruction
or
choledoch
duct
obstruction
caused
by
extrinsic
compression
of
an
impacted
stone
in
the
gallbladder
neck
or
cystic
duct
.
A
42
-
year
-old
woman
was
referred
to
the
emergency
department
with
symptoms
indicative
of
obstructive
icterus
.
Endoscopic
retrograde
cholangiopancreatography
(
ERCP
)
and
a
CT
scan
revealed
signs
of
Mirizzi
's
syndrome
but
no
indications
of
malignancy
.
Laparoscopic
cholecystectomy
was
decided
upon
.
This
procedure
revealed
that
the
obstruction
was
caused
by
a
gallbladder
carcinoma
.
Of
those
patients
suspected
of
having
Mirizzi
's
syndrome
,
retrospectively
5
-
28
%
prove
to
have
carcinoma
of
the
gallbladder
.
Therefore
in
Mirizzi
's
syndrome
before
carrying
out
laparoscopic
cholecystectomy
a
careful
diagnostic
approach
is
essential
.
This
includes
ERCP
or
MRI
cholangiopancreaticography
(
MRCP
)
and
a
CT
scan
.
Even
after
these
investigations
the
surgeon
should
only
perform
laparoscopic
surgery
with
caution
,
as
it
is
often
converted
to
an
open
procedure
and
because
of
the
risk
of
presence
of
a
malignancy
.
Diseases
Validation
Diseases presenting
"choledoch duct obstruction caused by extrinsic compression of an impacted stone in the gallbladder neck or cystic duct"
symptom
carcinoma of the gallbladder
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