title: Mirizzi syndrome type Va: A rare coexistence of double cholecysto-biliary and cholecysto-enteric fistulae.
abstract: Mirizzi syndrome is a rare cause of intermittent obstructive jaundice, where an impacted stone in the cystic duct or Hartmann's pouch mechanically obstructs the common bile duct (CBD). We report a rare case of double cholecysto-biliary and cholecysto-enteric fistulae, in a 75-year-old female patient, presenting with a right upper quadrant abdominal pain and intermittent obstructive jaundice. Endoscopic retrograde cholangiopancreatography suggested Mirizzi syndrome. Operative findings included erosions of the lateral wall of the CBD and the second portion of the duodenum due to impacted gallstones. The defects were reconstructed primarily and a Kehr tube was inserted. The patient had an uneventful postoperative course and was discharged on the 14th postoperative day.
authors.affiliation: Pavlos Lampropoulos, Nikolaos Paschalidis, Athanasios Marinis, Spiros Rizos, First Department of Surgery, Tzaneio General Hospital, Afentouli and Zanni STR, 18536, Piraeus, Greece.
authors.forename: Pavlos
authors.initials: P
authors.lastname: Lampropoulos
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Paschalidis
authors.forename: Athanasios
authors.initials: A
authors.lastname: Marinis
authors.forename: Spiros
authors.initials: S
authors.lastname: Rizos