Mirizzi's syndrome pathophysiology

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Pathophysiology

Mirizzi’s syndrome is caused by gallstone impaction in the cystic duct or neck of gallbladder resulting in chronic inflammation that leads to the compression, necrosis and fibrosis of common bile duct.
This can result in fistula formation into the adjacent structures like common hepatic duct or common bile duct.
The obstruction of bile duct either by direct compression from gallstone or scar formation results in obstructive jaundice.

Type I lesions involve external compression of the common bile duct without any fistula formation.

Type II lesions involve cholecystobiliary fistula with erosion of less than one‐third of the circumference of the bile duct.

Type III lesions are fistula that involve up to two‐thirds of the duct circumference.

Type V lesions described in 2008 by Beltran et al are any of the above 4 types plus the formation of cholecystoenteric fistula. ^[3] ^[1]

References

↑ ^1.0 ^1.1 Beltrán MA (September 2012). “Mirizzi syndrome: history, current knowledge and proposal of a simplified classification”. World J. Gastroenterol. 18 (34): 4639–50. doi:10.3748/wjg.v18.i34.4639. PMC 3442202. PMID 23002333.
↑ Csendes A, Díaz JC, Burdiles P, Maluenda F, Nava O (November 1989). “Mirizzi syndrome and cholecystobiliary fistula: a unifying classification”. Br J Surg. 76 (11): 1139–43. doi:10.1002/bjs.1800761110. PMID 2597969.
↑ Chen H, Siwo EA, Khu M, Tian Y (January 2018). “Current trends in the management of Mirizzi Syndrome: A review of literature”. Medicine (Baltimore). 97 (4): e9691. doi:10.1097/MD.0000000000009691. PMC 5794376. PMID 29369192.

Overview