Anderson Oliver, Faroug Radwane, Davidson Brian R, Goode J Antony
Royal Free Hospital & University College School of Medicine, University College London, London, UK.
J Med Case Rep. 2008 Nov 17;2:351. doi: 10.1186/1752-1947-2-351.
This is the first case report of Mirizzi syndrome associated with hepatic artery pseudoaneurysm.
A 54-year-old man presented with painful obstructive jaundice and weight loss. Computed tomography showed a hilar mass in the liver. Following an episode of haemobilia, angiography demonstrated a pseudoaneurysm of a branch of the right hepatic artery that was embolised. At surgery, a gallstone causing Mirizzi type II syndrome was found to be responsible for the biliary obstruction and a necrotic inflammatory mass and haematoma were found to be extending into the liver. The mass was debrided and drained, the obstructing stones removed and the bile duct drained with a t-tube. The patient made a full recovery.
This case highlights another situation where there may be difficulty in differentiating Mirizzi syndrome from biliary tract cancer.
这是首例与肝动脉假性动脉瘤相关的Mirizzi综合征病例报告。
一名54岁男性患者，出现疼痛性梗阻性黄疸和体重减轻症状。计算机断层扫描显示肝脏肝门部有肿块。在一次胆道出血事件后，血管造影显示右肝动脉分支存在假性动脉瘤，随后对其进行了栓塞治疗。手术中发现，一枚导致Mirizzi II型综合征的胆结石是造成胆道梗阻的原因，同时还发现坏死性炎性肿块和血肿延伸至肝脏。对肿块进行清创引流，取出梗阻结石，并通过T形管对胆管进行引流。患者完全康复。
该病例凸显了另一种在鉴别Mirizzi综合征与胆道癌时可能存在困难的情况。
