Mirizzi syndrome

Case contributed by Dr Craig Hacking

Presentation

Intermittent episodes of abdominal pain for one month, now with one week of persistent vomiting. Tender RUQ. Markedly deranged LFTs, normal lipase. Previous laparoscopic cholecystectomy.

Patient Data

Age: 45-50 years
Gender: Male
CT

Although has there has been prior cholecystectomy, a gallbladder stump persists (as seen on a recent MRCP). There is a partially peripherally calcified 9 mm calculus within the cystic duct which has migrated medially (since the external CT cholangiogram 9 days earlier). The cystic duct calculus is causing extrinsic compression of the common hepatic duct which is dilated measuring 16 mm (previously 8 mm on the CT cholangiogram). No intrahepatic duct dilatation.

Features are therefore in keeping with Mirizzi syndrome.

Incidental circumaortic left renal vein.

Case Discussion

Good example of Mirizzi syndrome and circumaortic left renal vein.

The patient had the stone removed and recovered well.

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Case information

rID: 37120
Case created: 27th May 2015
Last edited: 21st Aug 2017
Inclusion in quiz mode: Included

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