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Coexistence of Mirizzi syndrome with adenomyomatosis in the gallbladder: report of a case |
Abdulkadir Bedirli, Mustafa Kerem, Hasan Bostanci, Tarkan Karakan, T. Tolga Sahin and Nalan Akyurek |
Ankara, Turkey
Author Affiliations: Department of General Surgery (Bedirli A, Kerem M, Bostanci H and Sahin TT); Department of Gastroenterology (Karakan T); and Department of Pathology (Akyurek N), Gazi University Medical Faculty, Ankara, Turkey
Corresponding Author: Abdulkadir Bedirli, MD, Mesa Koru Sit. Fulya Blok, 85/39, 06810, Cayyolu, Ankara, Turkey (Tel: +90 312 2025724; Fax: +90 312 2124647; Email: bedirlia@gazi.edu.tr) |
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Abstract BACKGROUND: Mirizzi syndrome is a rare complication of cholelithiasis. Adenomyomatosis is a common tumor-like lesion of the gallbladder.
METHODS: A 52-year-old man was admitted to our hospital complaining of right hypochondriac pain and jaundice. Ultrasonography and computed tomography revealed stones in the gallbladder and dilation of the intrahepatic bile ducts. Magnetic resonance cholangiopancreatography revealed narrowing of the common bile duct caused by compression of the gallbladder. Laparotomy revealed type Ⅱ Mirizzi syndrome.
RESULTS: Partial cholecystectomy with a Roux-en-Y hepaticojejunostomy reconstruction was performed. Histologically, Rokitansky-Aschoff sinus proliferation, hypertrophy of smooth muscles, and fibrosis were seen in the gallbladder. A segmental type of adenomyomatosis of the gallbladder was diagnosed.
CONCLUSIONS: The pathogenic link between the two peculiar entities is unclear. A possible explanation is considered that the pathogenesis of Mirizzi syndrome is resulted from chronic inflammation due to adenomyomatosis.
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