Coexistence of Mirizzi syndrome with adenomyomatosis in the gallbladder: report of a case.
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.
Bedirli
Abdulkadir
A
Department of General Surgery, Gazi University Medical Faculty, Ankara, Turkey. bedirlia@gazi.edu.tr
Kerem
Mustafa
M
Bostanci
Hasan
H
Karakan
Tarkan
T
Sahin
T Tolga
TT
Akyurek
Nalan
N
D000713:Anastomosis, Roux-en-Y; D002763:Cholecystectomy; D002769:Cholelithiasis / Q000150:complications; D001651:Cholestasis, Extrahepatic / Q000150:complications* / Q000175:diagnosis*; D003135:Common Bile Duct / Q000473:pathology; D005355:Fibrosis; D005704:Gallbladder / Q000000981:diagnostic imaging / Q000473:pathology; D005705:Gallbladder Diseases / Q000150:complications* / Q000175:diagnosis*; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D013577:Syndrome; D014057:Tomography, X-Ray Computed / Q000379:methods; D014463:Ultrasonography / Q000379:methods