RAMOS PACHON, Carlos Manuel; HERNANDEZ RODRIGUEZ, Yoel; DEL VALLE LLUFRIO, Pedro    RUESCA DOMINGUEZ, Cristina. Mirizzi Syndrome Type IV: diagnosis and management through retrograde endoscopic cholangiopancreatography. Case report. []. , 35, 3, pp. 263-271. ISSN 1684-1824.

The Mirizzi syndrome is a cholelithiasis rare complication, characterized by the mechanical obstruction of the hepato choledocus duct by a calculus impacted in the cystic or in the vesicular neck. We presented a case with cholelithiasis antecedents entering the hospital with a clinical picture compatible with acute cholangitis.  We made an elective cholangiopancreatography finding a big protraction of the intrahepatic biliary tracts, stretch of the supraduodenal choledoc with  a common cystic-vesicular neck and choledocian environment, forming a great duct of near 20 mm diameter, having inside an ovoid filling mistake which bigger diameter is 15 mm, directed  to the choledocus and to the vesicle. We diagnosed a Mirizzi syndrome Type IV. In a patient with those characteristics, the cholangiopancreatography is an unavoidable diagnostic and therapeutic method.

: síndrome de Mirizzi; colangiopancretografía retrógrada endoscópica; colelitiasis; Mirizzi syndrome; endoscopic retrograde cholangiopancreatography; cholelithiasis.

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