Alqahtani Awadh, Atif Qurrat Al Ain
FRCSC(Surgical Oncology), Consultant Laparoscopic and Bariatric Surgery, King Saud Medical University, Riyadh, Saudi Arabia.
MRCS(Eng), FCPS(Pak), Dip. Laparoscopic Surgery (France), General Surgery Specialist, Dr. Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia.
Int J Surg Case Rep. 2020;72:438-442. doi: 10.1016/j.ijscr.2020.06.040. Epub 2020 Jun 15.
Mirizzi's syndrome is a rare but potential complication of long standing gallstone disease, particularly cholecystolithiasis.
Being described is a case of a 42 year old patient who presented with right upper quadrant pain. Initially sent home as the pain settled but was diagnosed as Mirrizi's syndrome on readmission and was managed accordingly. This case report is being presented with the aim of highlighting the importance of Mirizzi's syndrome and the potential consequences it may bear.
Due to lack of symptom specificity, this entity remains undiagnosed preoperatively in majority of the cases. Although safe in expert hands, minimally invasive approach (in selected types) can be challenging and bears the risk of bile duct injuries, with a high probability of conversion.
Delays in targeted management may lead to dire consequences ranging from empyema gallbladder to gangrene of gall bladder wall, perforation and frank sepsis. A thorough clinical history and physical examination and assessment in light of clinical investigations can lead to a timely diagnosis and management.
Mirizzi综合征是一种罕见但长期胆结石疾病（尤其是胆囊结石）可能引发的并发症。
本文描述了一名42岁患者，其表现为右上腹疼痛。最初因疼痛缓解被送回家，但再次入院时被诊断为Mirizzi综合征并得到相应治疗。本病例报告旨在强调Mirizzi综合征的重要性及其可能带来的潜在后果。
由于缺乏症状特异性，大多数病例在术前仍未得到诊断。尽管在专家手中微创手术是安全的，但（在某些特定类型中）微创手术具有挑战性，存在胆管损伤风险，且转为开放手术的可能性很高。
针对性治疗的延迟可能导致严重后果，从胆囊积脓到胆囊壁坏疽、穿孔和严重脓毒症。全面的临床病史、体格检查以及结合临床检查进行评估可实现及时诊断和治疗。
