Haq Razi, Chatterton Bradley, Gesner Lyle
Cooperman Barnabas Medical Center, Rutgers RWJ Barnabas Health, 94 Old Short Hills Rd, Livingston, NJ 07039 USA.
Radiol Case Rep. 2023 Mar 9;18(5):1890-1894. doi: 10.1016/j.radcr.2023.01.102. eCollection 2023 May.
The patient is a 54-year-old female who presented to the emergency department for episodic right biliary colic with nausea and vomiting over the past year. The patient's symptoms warranted multiple emergency department visits, but were self-limiting. During the most recent visit, the patient had a low-grade fever of 99.8°F (96.8°F-99.5°F) and a borderline elevated total bilirubin of 1.2 (0.2-1.2 mg/dL). Abdominal ultrasound revealed cholelithiasis, gallbladder wall thickening, and biliary ductal dilatation. Subsequent MRCP revealed an impacted stone within the gallbladder neck and a prominent common hepatic duct, compatible with Mirizzi syndrome Type I. The obtained imaging combined with clinical correlation in the setting of jaundice and right upper quadrant pain guided the patient's management. A laparoscopic cholecystectomy was performed and the patient was safely discharged the following day.
该患者为一名54岁女性，过去一年因间歇性右胆绞痛伴恶心呕吐前往急诊科就诊。患者的症状需要多次前往急诊科，但症状为自限性。在最近一次就诊时，患者低热，体温为99.8°F（96.8°F - 99.5°F），总胆红素临界升高至1.2（0.2 - 1.2mg/dL）。腹部超声显示胆结石、胆囊壁增厚和胆管扩张。随后的磁共振胰胆管造影（MRCP）显示胆囊颈部有嵌顿结石，肝总管突出，符合Ⅰ型Mirizzi综合征。所获得的影像学检查结果结合黄疸和右上腹疼痛情况下的临床相关性，指导了患者的治疗。进行了腹腔镜胆囊切除术，患者于次日安全出院。
