Mirizzi's syndrome: A scoring system for preoperative diagnosis

Tataria, Rachana D; Salgaonkar, Hrishikesh; Maheshwari, Gaurav; Halder, P. J.

doi:10.4103/sjg.sjg_6_18

Cited by 9 publications

(5 citation statements)

References 29 publications

(45 reference statements)

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“…CT proved to be approximately as sensitive as the US in our review, but it was repeatedly pointed out that its main advantage is differentiating MS from malignant strictures [31,32]. MS is listed as one of the diseases mimicking cholangiocarcinoma, but the fact us that the coexistence of MS and GBC is no less important [33,[39][40][41]. Prasad et al reported that patients with MS and simultaneous GBC were a decade older than and had twice as long a history of symptoms as patients who only had MS alone [33].…”

Section: Discussionmentioning

confidence: 76%

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The Current Approach to the Diagnosis and Classification of Mirizzi Syndrome

et al. 2021

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Mirizzi syndrome occurs in up to 6% of patients with cholecystolithiasis. It is generally caused by external compression of the common hepatic duct by a gallstone impacted in the neck of the gallbladder or the cystic duct, which can lead to fistulisation. The aim of this review was to highlight the proposed classifications for Mirizzi syndrome (MS) and to provide an update on modern approaches to the diagnosis of this disease. We conducted research on various internet databases and the total number of records was 993, but after a gradual process of elimination our final review consisted of 21 articles. According to the literature, the Cesendes classification is the most commonly used, but many new suggestions have appeared. Our review shows that the ultrasonography (US) is the most frequently used method of initial diagnosis, despite still having only average sensitivity. Magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP) are good methods and are similarly effective, but only the latter can be simultaneously therapeutic. Some modern methods show very high sensitivity, but are not so commonly administered. Mirizzi syndrome is still a diagnostic challenge, despite the advancement of the available tools. Preoperative diagnosis is crucial to avoid complications during treatment. New research may bring a unification of classifications and diagnostic algorithms.

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Section: Discussionmentioning

confidence: 76%

“…There were 32 patients with MS. The authors further evaluated the patients according to the scoring system they had developed and conducted a statistical analysis which showed that a score of 3 or more out of 10 has a sensitivity of 90.6% and specificity of 78.1% in predicting the Mirizzi syndrome [41].…”

Section: Discussionmentioning

confidence: 99%

The Current Approach to the Diagnosis and Classification of Mirizzi Syndrome

et al. 2021

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“…To our knowledge, sensitivity and specificity data for the detection of cholecystoduodenal fistulas by ERCP, MRCP, CT, and ultrasound have not been reported. However, the sensitivity and specificity data for the detection of related conditions such as gallstone ileus and Mirizzi syndrome (another type of internal biliary fistula, cholecystocholedochal fistula, is classified as type 2 Mirizzi syndrome [12,13]) have been reported. CT has been reported to be up to 93% sensitive and 100% specific for the detection of gallstone ileus [14], and ERCP has been reported to have a mean sensitivity of 76.2% for Mirizzi syndrome [15][16][17]; indeed, a 2013 study suggested a 100% sensitivity rate of ERCP for Mirizzi syndrome [18].…”

Section: Discussionmentioning

confidence: 99%

Cholecystoduodenal Fistula Evading Imaging and Endoscopic Retrograde Cholangiopancreatography: A Case Report

Lee¹,

Ramcharan²,

Alaimo³

et al. 2021

Cureus

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Cholecystoduodenal fistulas are a type of internal biliary fistula that occur due to chronic inflammation of the gallbladder/biliary tree; if left untreated, perforation and necrosis can occur. Cholecystoduodenal fistulas are often difficult to diagnose due to their non-specific signs and symptoms. Since the widespread use of techniques such as magnetic resonance cholangiopancreatography and imaging modalities such as computed tomography, the frequency of reports describing intraoperative cholecystoduodenal fistula has reduced dramatically.Here, we report the case of a 54-year-old female who presented with a two-day history of non-radiating epigastric abdominal pain, initially diagnosed with acute cholecystitis and choledocholithiasis. Upon undergoing laparoscopic cholecystectomy, she was found to have extensive fibrosis of the gallbladder, adhesions, and an impacted gallstone in the wall of the gallbladder. Imaging and endoscopic retrograde cholangiopancreatography performed prior to surgery did not detect a cholecystoduodenal fistula that was discovered intraoperatively. She was treated successfully with laparoscopic cholecystectomy and repair of the duodenum.

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“…This syndrome is a complication of prolonged cholelithiasis, with prevalence from 0.05% to 2.7% among patients with calculi of the gallbladder. It presents a spectrum that varies from extrinsic compression of the CHD to the presence of cholecystobiliary fistula [ 2 ]. Usually, this syndrome is associated with cholecystobiliary fistula (cholecystohepatic or cholecystocholedochal), as in type II or III according to Csendes et al classification, but the presence of an internal biliary fistula as cholecystoduodenal, cholecystocolonic or cholecystogastric requires the most recent Beltran Classification, in which Type V has been introduced to describe the cholecystoenteric fistula, with or without gallstone ileus [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Mirizzi syndrome type V complicated with triple fistula: a case report

Lalountas,

Smyrlis,

Mouratidis

et al. 2023

surg case rep

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Background Mirizzi syndrome (MS) is a complicated form of longstanding, symptomatic cholelithiasis. According to Beltran Classification MS Type V has been introduced to describe the cholecystoenteric fistula, with or without gallstone ileus. Mirizzi syndrome Type V with double fistula has been reported in the past; however, the triple fistula is an even rarer case, first described in the international literature so far. Case presentation A 77-year-old male was admitted to our surgical department with recurrent episodes of abdominal pain, which initially presented in the last 6 months and was accompanied with jaundice. Computed tomography showed findings of cholelithiasis, pneumobilia and choledocholithiasis. We performed an ERCP, which showed two fistulas of the gallbladder with the pyloric antrum and the duodenum, respectively. Surgical treatment was immediately undergone and during laparotomy, we confirmed these findings. We ligated and dissected these communications. In addition, a third fistula between the gallbladder and the common bile duct was identified. An insertion of a Kehr T-tube into the common bile duct was performed via the gallbladder. After 3 months, the Kehr T-tube was removed and in the subsequent 2 years of follow-up the patient was presented without complications. Conclusions Mirizzi syndrome complicated with triple fistula, first described in the international literature, to the best of our knowledge, confirms the long natural history of inflammation.

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Mirizzi's syndrome: A scoring system for preoperative diagnosis

Cited by 9 publications

References 29 publications

The Current Approach to the Diagnosis and Classification of Mirizzi Syndrome

The Current Approach to the Diagnosis and Classification of Mirizzi Syndrome

Cholecystoduodenal Fistula Evading Imaging and Endoscopic Retrograde Cholangiopancreatography: A Case Report

Mirizzi syndrome type V complicated with triple fistula: a case report

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