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Image of the Month—Diagnosis
Corresponding author: Rabih M. Salloum, MD, Department of Surgery, University of Rochester School of Medicine, Box SURG, Rochester, NY 14642 (e-mail: Rabih_Salloum{at}urmc.rochester.edu).
Arch Surg. 2004;139:450.
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Answer: Mirizzi Syndrome
Figure 1. Computed tomographic scan of the abdomen.
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Figure 2. Classification of Mirizzi syndrome.
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The CT scan of the abdomen revealed a large complex cystic mass 13 x 12 x 10 cm in the area of the porta hepatis and gallbladder fossa (Figure 1A, B, and C). At closer inspection, the mass was displacing the duodenum and pancreatic head to the left, and a clear plane between the mass and pancreatic head was visible (Figure 1D). Biliary ductal dilatation was also visible, and a normal portal vein was seen (Figure 1D, arrow).
The patient underwent exploratory laparotomy through a right subcostal incision. Findings at the time of surgery were a large cyst of the gallbladder with multiple stones and copious sludge. An intraoperative cholangiogram demonstrated normal biliary anatomy, and cholecystectomy was performed. The patient had an uneventful postoperative . . . [Full Text of this Article]
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Arch Surg. 2004;139(4):449.
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