MIRIZZI SYNDROME TYPE I MIMICKING CHOLANGIOCARCINOMA: A CASE REPORT AND LITERATURE REVIEW
Main Article Content
Abstract
Mirizzi syndrome is a rare cause of obstructive jaundice, resulting from an impacted gallstone in the gallbladder neck or cystic duct, leading to extrinsic compression of the common hepatic duct, with or without the presence of a cholecysto-biliary fistula. Clinically and radio-logically, it may mimic malignant conditions at the hepatic hilum, such as cholangiocarcinoma, making preoperative diagnosis challenging. We report a case of a 32-year-old female patient who was admitted with upper abdominal pain and progressive jaundice. The initial diagnosis was cholangiocarcinoma based on clinical presentation, elevated CA 19-9 levels, and imaging findings. However, Mirizzi syndrome was confirmed intraoperatively, and the surgical strategy was accordingly modified. Mirizzi syndrome poses a diagnostic challenge pre-operatively due to its similarity to other causes of obstructive jaundice. A high index of suspicion and careful intraoperative assessment are essential for accurate diagnosis and to avoid unnecessary extensive surgery.
Keywords
Mirizzi syndrome, cholangiocarcinoma, obstructive jaundice
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
References
2. Payá-Llorente C., Vázquez-Tarragón A., Alberola-Soler A. Updated management of Mirizzi syndrome: A systematic review. Annals of Hepato-Biliary-Pancreatic Surgery. 2021. 25(2), 181–191, doi: https://doi.org/10.14701/ahbps.2021.25.2.181.
3. Chen H., Siwo E.A., Khu M., Tian Y. Current trends in the management of Mirizzi syndrome: A review of literature. Medicine. 2020. 99(4), e18783, doi: https://doi.org/10.1097/MD.0000000000018783
4. Steinberg W. Clinical utility of CA 19-9 in benign and malignant biliary disease. Gastroenterology Review. 2020. 15(1), 1–6. https://doi.org/10.5114/pg.2020.93194.
5. Marrelli D., Caruso S., Pedrazzani C. CA 19-9 elevation in benign biliary diseases: clinical significance. International Journal of Biological Markers. 2021. 36(2), 1–7, doi: https://doi.org/10.1177/172460082110103.
6. Xu X., Hong T., Li B. Role of MRCP in diagnosis of Mirizzi syndrome. BMC Medical Imaging. 2022. 22, 45, doi: https://doi.org/10.1186/s12880-022-00779-1
7. Yilmaz E.M., Kirimlioglu V. Diagnostic accuracy of imaging modalities in Mirizzi syndrome. Surgical Laparoscopy Endoscopy & Percutaneous Techniques. 2021. 31(3), 345–350, doi: https://doi.org/10.1097/SLE.0000000000000890.
8. Antoniou S.A., Antoniou G.A., Makridis C. Laparoscopic treatment of Mirizzi syndrome: systematic review. Surgical Endoscopy. 2020. 34(2), 509–520, doi: https://doi.org/10.1007/s00464-019-06742-7.
9. Gómez D., Rahman S.H., Toogood G.J., Lodge J.P. Mirizzi syndrome: diagnosis and management. HPB. 2022. 24(5), 655–662, doi: https://doi.org/10.1016/j.hpb.2021.10.008.