ミリッツィー症候群
WordNet
- a pattern of symptoms indicative of some disease
- a complex of concurrent things; "every word has a syndrome of meanings"
PrepTutorEJDIC
- (疾患の徴候となる一群の)症徴候,症候群 / (事件・社会的状態などのパターンを示す)徴候形態
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出典(authority):フリー百科事典『ウィキペディア(Wikipedia)』「2013/05/25 14:12:24」(JST)
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Mirizzi's syndrome |
Classification and external resources |
ICD-9 |
576.2 |
DiseasesDB |
33254 |
eMedicine |
radio/451 |
Mirizzi's syndrome is a rare complication in which a gallstone becomes impacted in the cystic duct or neck of the gallbladder causing compression of the common bile duct (CBD) or common hepatic duct, resulting in obstruction and jaundice. The obstructive jaundice can be caused by direct extrinsic compression by the stone or from fibrosis caused by chronic cholecystitis (inflammation). A cholecystocholedochal fistula can occur.[1]
Contents
- 1 Epidemiology
- 2 Pathophysiology
- 3 Features
- 4 Diagnosis
- 5 Treatment
- 6 Eponym
- 7 References
- 8 External links
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Epidemiology [edit]
Mirizzi syndrome occurs in approximately 0.1% of patients with gallstones.[2] It occurs in 0.7 to 2.5 percent of cholecystectomies.[1]
It affects males and females equally, but tends to affect older people more often. There is no evidence of race having any bearing on the epidemiology.
Pathophysiology [edit]
Multiple and large gallstones can reside chronically in the Hartmann's pouch of the gallbladder, causing inflammation, necrosis, fibrosis and ultimately fistula formation into the adjacent common bile duct (CBD). As a result, the CBD becomes obstructed by either scar or stone, resulting in jaundice. It can be divided into four types.
Type I - No fistula present
- Type IA - Presence of the cystic duct
- Type IB - Obliteration of the cystic duct
Types II-IV - Fistula present
- Type II - Defect smaller than 33% of the CBD diameter
- Type III - Defect 33-66% of the CBD diameter
- Type IV - Defect larger than 66% of the CBD diameter
Features [edit]
Mirizzi syndrome has no consistent or unique clinical features that distinguish it from other more common forms of obstructive jaundice. Symptoms of recurrent cholangitis, jaundice, right upper quadrant pain, and elevated bilirubin and alkaline phosphatase may or may not be present. Acute presentations of the syndrome include pancreatitis or cholecystitis.
Diagnosis [edit]
Imaging by CT scan or ultrasonography usually make the diagnosis.[3] Often, ERCP is used to define the lesion anatomically prior to surgery. MRCP is more often used to define the anatomy prior to surgery.
Treatment [edit]
The treatment of choice is laparotomic surgical excision of the gallbladder, and reconstruction of the common hepatic duct and common bile duct.
Eponym [edit]
It is named for Pablo Luis Mirizzi, an Argentinian physician.[4][5]
References [edit]
- ^ a b Vitale M. Mirizzi Syndrome Type IV: An Atypical Presentation That Is Difficult to Diagnose Preoperatively. 2009. Society for Surgery of the Alimentary Tract.http://www.ssat.com/cgi-bin/abstracts/09ddw/P7.cgi
- ^ Hazzan, D; D Golijanin, P Reissman, SN Adler, E Shiloni (06 1999). "Combined endoscopic and surgical management of Mirizzi syndrome". Surgical Endoscopy 13 (6): 618–20. doi:10.1007/s004649901054. PMID 10347304.
- ^ Ross, Jeffrey W; Gary S Sudakoff, Gregory B Snyder, Neela Lamki (editor), Bernard D Coombs (editor), Abraham H Dachman (editor), Robert M Krasny (editor), John Karani (editor) (2006-12-29). "Mirizzi syndrome". eMedicine. WebMD. Retrieved 2007-12-09.
- ^ synd/3587 at Who Named It?
- ^ Mirizzi PL: Syndrome del conducto hepatico. J Int de Chir 1948; 8: 731-77
External links [edit]
- Mirizzi Syndrome Explained in USMLE Forums
UpToDate Contents
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English Journal
- Mirizzi syndrome: recognition on magnetic resonance cholangiopancreatography.
- Gupta M, Garg D.SourceSantosh University Medical College and Hospital, Ghaziabad, India.
- Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.Clin Gastroenterol Hepatol.2012 Dec;10(12):A32. doi: 10.1016/j.cgh.2012.08.007. Epub 2012 Aug 14.
- PMID 22902279
- Diagnosis and treatment of xanthogranulomatous cholecystitis: a report of 39 cases.
- Han SH, Chen YL.SourceDepartment of Hepatobiliary Surgery, The Affiliated Union Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China, hansh@medmail.com.cn.
- Cell biochemistry and biophysics.Cell Biochem Biophys.2012 Nov;64(2):131-5. doi: 10.1007/s12013-012-9381-y.
- This study focuses on providing diagnosis and treatment for xanthogranulomatous cholecystitis (XGC). Clinical data from 39 patients diagnosed with XGC by pathological examination between 2002 and 2010 were analyzed retrospectively. As a result, in this group of patients, the male to female ratio was
- PMID 22707297
Japanese Journal
- Mirizzi 症候群様所見を契機に発見された cystohepatic duct の1例
- 山内 靖,加藤 大祐,佐々木 隆光,新屋 智志,星野 誠一郎,山下 裕一
- 日本臨床外科学会雑誌 = The journal of the Japan Surgical Association 71(8), 2110-2114, 2010-08-25
- NAID 10026668686
- Mirizzi 症候群に対する胆道再建後, 特異な経過でIgG4関連硬化性胆管炎と診断された1例
- 岡 智,泉 貞言,鈴鹿 伊智雄,塩田 邦彦,中村 聡子,間野 正平
- 日本臨床外科学会雑誌 = The journal of the Japan Surgical Association 71(2), 484-488, 2010-02-25
- NAID 10026341100
Related Pictures
★リンクテーブル★
[★]
- 英
- Mirizzi syndrome, Mirizzi's syndrome
- 同
- ミリッシ症候群 ミリッチー症候群 Mirizzi症候群、肝管狭窄症 hepatic duct stenosis
[show details]
jp 111116
ミリッチー症候群 : 81 件
ミリッツィ症候群 : 50 件
ミリッシ症候群 : 81 件
ミリッツィー症候群 : 6 件
jp
ミリッシ症候群 : 3 件
ミリッチー症候群 : 6 件
ミリッツィー症候群 : 7 件
Mirizzi症候群 : 約 1,920 件
Mirizzi syndrome : 87 件
Mirizzi's syndrome : 30 件
en
ミリッシ症候群 : nothing
ミリッチー症候群 : nothing
ミリッツィー症候群 : nothing
Mirizzi症候群 : 9 件
Mirizzi syndrome : 約 26,000 件
Mirizzi's syndrome : 約 28,600 件
概念
参考
- http://journal.jsgs.or.jp/pdf/019050925.pdf
- 2. [charged] Mirizzi syndrome - uptodate [1]
[★]
- 英
- Mirizzi sign, Mirizzi's sign
- 関
- ミリッツィー症候群
参考
- Yoshihiro Baba et al, Proceedings of the 69th General Meeting from April 11?13, 1983-Osaka, Japan, Journal of Gastroenterology, Volume 19, Number 2, 136-196, DOI: 10.1007/BF02806937
- http://www.springerlink.com/content/b368512718568w7h/
- From these facts the name of Mirizzi's sign instead of Mirizzi syndrome should be clinically given to the patients when they are diagnosed as benign inflammatory stricture of common hepatic bile duct after every possible examination.
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