Abstract
An: 2015, Nr.1, Articol Nr. 12
Title: 

ACUTE ACALCULOUS CHOLECYSTITIS COMPLICATED WITH OBSTRUCTIVE JAUNDICE – AN UNCOMMON VARIANT OF MIRIZZI SYNDROME. ANATOMICAL CONSIDERATIONS

Authors: 

      A. Miron - . “Elias” University Emergency Hospital, Bucharest, General Surgery Clinic; “Carol Davila“ University of Medicine and Pharmacy, Bucharest
      M. Nădragea, C. Giulea - . “Elias” University Emergency Hospital, Bucharest, General Surgery Clinic
      O. Enciu - “Carol Davila“ University of Medicine and Pharmacy, Bucharest
      ACUTE ACALCULOUS CHOLECYSTITIS COMPLICATED WITH OBSTRUCTIVE JAUNDICE – AN UNCOMMON VARIANT OF MIRIZZI SYNDROME. ANATOMICAL CONSIDERATIONS (Abstract): Acute acalculous cholecystitis is rare entity and can be complicated by extrinsic compression of the common hepatic / bile duct by the enlarged gallbladder. The extrinsic compression is similar to that seen in Mirizzi type 1 syndrome by an impacted stone in Hartmann’s pouch or the cystic duct. Acalculous cholecystitis with extrinsic compression of the bile duct is a very rare situation, very few cases being published. We present the case of a 24 year old patient with compression of the common hepatic duct by the enlarged gallbladder infundibulum in the absence of gallstones. The compression was confirmed by MRI and by intraoperative cholangiography. Laparoscopic cholecystectomy was performed and the patient had an uneventful rapid recovery. The anatomic design in our case and the few other published was an elongated cystic duct with a parallel course to the hepatic duct bringing the infundibulum in close vicinity to the common hepatic duct. Although a very uncommon clinical setting, clinicians and surgeons should be aware that acute acalculous cholecystitis can present as a Mirizzi syndrome. Laparoscopic surgery per se can offer the means to diagnose and treat this form of obstructive jaundice, extending the surgical indication in the absence of gallstone disease.
Key words: ACUTE ACALCULOUS CHOLCYSTITIS, LAPAROSCOPIC SURGERY, OBSTRUCTIVE JAUNDICE
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