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Impacted gallstone in the cystic duct is obstructing the common hepatic duct. Mirizzi's syndrome is a rare complication in which a gallstone becomes impacted in the cystic duct or neck of the gallbladder causing compression of the common hepatic duct, resulting in obstruction and jaundice.
The cystic duct may unite with the common hepatic duct so that the common hepatic duct is either very short or very long (and the bile duct in turn very long or very short, respectively), [4] or it may instead unite with the a hepatic duct. [3] Occasionally, the cystic duct may first run alongside the common hepatic duct for some distance [2 ...
Without appropriate treatment, recurrent episodes of cholecystitis are common. [1] Complications of acute cholecystitis include gallstone pancreatitis, common bile duct stones, or inflammation of the common bile duct. [1] [8] More than 90% of the time acute cholecystitis is caused from blockage of the cystic duct by a gallstone. [1]
Biliary pain is most frequently caused by obstruction of the common bile duct or the cystic duct by a gallstone. However, the presence of gallstones is a frequent incidental finding and does not always necessitate treatment, in the absence of identifiable disease.
In this obstructed state, the duct is especially vulnerable to an infection called ascending cholangitis. One form of treatment is a cholecystenterostomy. Rare deformities of the common bile duct are cystic dilations (4 cm), choledochoceles (cystic dilation of the ampula of Vater (3–8 cm)), and biliary atresia.
The first is how often and how well the gallbladder contracts; incomplete and infrequent emptying of the gallbladder may cause the bile to become overconcentrated and contribute to gallstone formation. This can be caused by high resistance to the flow of bile out of the gallbladder due to the complicated internal geometry of the cystic duct. [36]
Type V: Cystic dilatation of intrahepatic biliary ducts without extrahepatic duct disease. The presence of multiple saccular or cystic dilations of the intrahepatic ducts is known as Caroli's disease. [4] Type VI: An isolated cyst of the cystic duct is an extremely rare lesion. Only single case reports are documented in the literature.
The exceptions to the law are stones that dislodge and acutely block the duct distally to the hepatic/cystic duct junction: Double gallstones with one falling and blocking the common bile duct (responsible for jaundice) and one at the cystic duct (palpable non-tender gallbladder results from precisely a mucocele of the fibrotic gallbladder)