肝管梗阻症候群併肝膿瘍：一例報告與文獻回顧

Mirizzi's Syndrome with Liver Abscess: A Case Report and Review of Literature

王柏川(Po-Chuan Wang) ； 施壽全(Show-Chyuan Shy) ； 劉建良(Jiann-Liang Liou) ； 池永昌(Yeong-Chang Chyr)

《中華民國急救加護醫學會雜誌》 7卷4期 (1996/12) Pp. 170-175

https://doi.org/10.30018/JECCM.199612.0005

摘要

膽囊管或膽囊結石所致之阻塞性黃膽，在臨床上是很少見的。其香生的基本要素為：膽囊管進入總膽管的位置較低，使得膽囊管較平行於總肝管；當膽囊管內或膽囊內的結石夠大而壓迫到總肝管時，便造成阻塞性黃膽。本文報告一60歲男性病人，以高燒、急性右上腹痛、黃膽為臨床表現。經超音波，電腦斷層，及內視鏡逆行性膽道攝影，證實為肝管梗阻症候群併肝膿瘍。文中討論術前診斷的重要性，處理方式，並做文獻回顧。

關鍵字

肝管梗阻症候群 ； 肝膿瘍

並列摘要

Mirizzi's syndrome is a rare entity of common hepatic duct obstruction by gall stone or cystic duct stone. It comprises the following features: lower insertion of the cystic duct such that it lies almost parallel to the common hepatic duct; impaction of a gallstone in the cystic duct or neck of the gallbladder; mechanical obstruction of the common hepatic duct by the stone itself or inflammatory reaction; and recurrent cholangitis. We report the case of 60-year-old male who visited our emergency room with fever, jaundice and right upper quadrant pain. After a series of studies including sonography, computed tomography and endoscopic retrograde cholangiography, Mirizzi's syndrome with a liver abscess was diagnosed. We emphasize the importance of an accurate diagnosis prior to operation, discuss the management of the Mirizzi's syndrome, and review the literature.

並列關鍵字

Mirizzi's syndrome ； liver abscess