+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Complications of gallstone disease: Mirizzi syndrome, cholecystocholedochal fistula, and gallstone ileus



Complications of gallstone disease: Mirizzi syndrome, cholecystocholedochal fistula, and gallstone ileus



American Journal of Gastroenterology 97(2): 249-254



Gallstone is a common disease with a 10% prevalence in the United States and Western Europe. However, it is only symptomatic in 20-30% of patients, with biliary pain "colic" being the most common symptom. Complications of asymptomatic gallstone disease are generally rare, with an incidence of <1 %/yr. The most common complications of gallstone disease are acute cholecystitis, acute pancreatitis, ascending cholangitis, and gangrenous gallbladder. Less frequent complications include Mirizzi syndrome, cholecystocholedochal fistula, and gallstone ileus. Mirizzi syndrome and cholecystocholedochal fistula are two manifestations of the same process that starts with impaction of a gallstone in the gallbladder neck that results in obstruction of the bile duct, causing jaundice. The gallstone may erode into the bile duct, causing cholecystocholedochal fistula. Gallstone ileus refers to small bowel obstruction resulting from the impaction of one or more gallstones after they have migrated through a cholecystoenteric fistula. An accurate diagnosis is essential to the management and prevention of further complications. A variety of imaging and endoscopic modalities are used to make the diagnosis once the condition is suspected clinically. Treatment should be tailored to each individual patient. Management choices include ERCP, lithotripsy (endoscopic or extracorporeal), and surgery. Prognosis is frequently related to early recognition, management of any comorbid conditions, and careful selection of treatment modalities.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 010367735

Download citation: RISBibTeXText

PMID: 11866258

DOI: 10.1016/s0002-9270(01)04013-8


Related references

Mirizzi syndrome and gallstone ileus: an unusual presentation of gallstone disease. Journal of Gastrointestinal Surgery 9(5): 686-689, 2005

Gallstone Disease: Cholecystitis, Mirizzi Syndrome, Bouveret Syndrome, Gallstone Ileus. Surgical Clinics of North America 99(2): 231-244, 2019

Complications of gallstones: the Mirizzi syndrome, gallstone ileus, gallstone pancreatitis, complications of "lost" gallstones. Surgical Clinics of North America 88(6): 1345-68, X, 2008

Spontaneous internal biliary fistulas from gallstones: Mirizzi's syndrome, cholecystoenteric fistula, and gallstone ileus. American Surgeon 80(4): 409-411, 2014

Complications of gallstone disease: gallstone ileus. American Journal of Gastroenterology 97(7): 1843-4; Author Reply 1844, 2002

Development of a duodenal gallstone ileus with gastric outlet obstruction (Bouveret syndrome) four months after successful treatment of symptomatic gallstone disease with cholecystitis and cholangitis: a case report. Journal of Medical Case Reports 4: 376, 2010

Gallstone Ileus Caused by Cholecystocolonic Fistula and Gallstone Impaction in the Sigmoid Colon: Review of the Literature and Novel Surgical Treatment with Trephine Loop Colostomy. Case Reports in Gastroenterology 11(1): 95-102, 2017

Duodenal perforation due to a gallstone in small intestinal gallstone ileus: "Bouveret's syndrome". Turkish Journal of Gastroenterology 20(3): 232-233, 2010

Gallstone ileus: plea for simultaneous treatment of obstruction and gallstone disease. Journal de Chirurgie 134(2): 59-64, 1997

Complicated gallstone disease: diagnosis and management of Mirizzi syndrome. Surgical Endoscopy 31(5): 2215-2222, 2016

Mirizzi syndrome with cholecystocholedochal fistula: preoperative diagnosis and management. Surgery 111(3): 335-338, 1992

Gallstone ileus and Crohn's disease without biliary-enteric fistula: report of a unique case. Mount Sinai Journal of Medicine, New York 67(2): 159-162, 2000

Choledochoplasty for cholecystocholedochal fistula (Mirizzi syndrome type II): a case report and literature review. Australian and New Zealand Journal of Surgery 65(4): 285-288, 1995

Recurrent gallstone ileus due to a residual gallstone: A case report and literature review. International Journal of Surgery Case Reports 13: 12-14, 2015

A case of recurrent gallstone ileus: the fate of the residual gallstone remains unknown. BMJ Case Reports 2014, 2014