Mirizzi Syndrome Complicated With Transverse Colon Fistula Presenting as Colonic Tumor: A Case Report and Literature Review

Abstract

Summary: An 88-year-old man was admitted because of right upper quadrant abdominal pain and diagnosed as having acute cholecystitis. He underwent endoscopic retrograde cholangiography for jaundice and showed common hepatic duct narrowing with external compression compatible with Mirizzi syndrome. Owing to his age and fragility, he received only internal drainage with a plastic stent instead of operation. The right upper quadrant abdominal pain recurred with bloody stool and decreased hemoglobin level. Colonoscopy revealed a 4- × 3-cm colonic tumor over the hepatic flexure, and colonoscopic biopsy revealed necrosis and inflammation. Abdominal computed tomography (CT) revealed ruptured acute cholecystitis and abscess formation. Surgical intervention was performed, and the operative finding showed a cholecystocolonic fistula. The patient was discharged after cholecystectomy and partial colectomy, and the period of secondary hospitalization was 46 days. Keywords: acute cholecystitis, cholecystocolonic fistula, colonic tumor, Mirizzi syndrome