急性无结石性胆囊炎所致梗阻性黄疸：“Mirizzi样综合征”
Obstructive jaundice due to acute acalculous cholecystitis: 'Mirizzi-like syndrome'.
作者信息
Sakamoto Takashi, Lefor Alan Kawarai, Takasaki Tetsuro
机构信息
Department of Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Chiba, Japan
Department of Surgery, Jichi Medical University, Shimotsuke, Tochigi, Japan.
出版信息
BMJ Case Rep. 2021 Mar 30;14(3):e239564. doi: 10.1136/bcr-2020-239564.
A 78 year-old female status post subarachnoid haemorrhage developed abdominal pain and obstructive jaundice. CT scan showed acute cholecystitis and dilation of the intrahepatic ducts. Endoscopic retrograde cholangiography revealed hepatic duct stenosis due to compression by an enlarged gallbladder. No stones were seen in the common hepatic duct and the cystic duct was patent. An endoscopic retrograde biliary drain was placed to relieve the obstructive jaundice due to acute acalculous cholecystitis. Percutaneous transhepatic drainage was performed to treat the acute acalculous cholecystitis. Hepatic duct stenosis was improved on endoscopic retrograde cholangiography performed 19 days after percutaneous transhepatic drainage. It may be reasonable to treat 'Mirizzi-like syndrome' non-operatively.
一名78岁蛛网膜下腔出血后的女性出现腹痛和梗阻性黄疸。CT扫描显示急性胆囊炎和肝内胆管扩张。内镜逆行胆管造影显示肝管狭窄是由于肿大的胆囊压迫所致。肝总管未见结石，胆囊管通畅。放置了内镜逆行胆管引流以缓解急性非结石性胆囊炎所致的梗阻性黄疸。进行了经皮经肝胆管引流以治疗急性非结石性胆囊炎。经皮经肝胆管引流19天后进行的内镜逆行胆管造影显示肝管狭窄有所改善。非手术治疗“Mirizzi样综合征”可能是合理的。
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