Presentation
Abdominal pain for the last one week.
Patient Data
The gallbladder is distended and contains some sludge with several low signal filling defects, less than 25mm, inferring stones. One of them is located in the gallbladder neck, exerting extrinsic compression on the adjacent CBD, causing severe diffuse intrahepatic bile ducts dilatation. The maximum caliber of CBD in the proximal and distal segments measures 22mm and 9mm respectively.
Case Discussion
The features on MRCP are most consistent with Mirizzi syndrome which refers to extrinsic compression of extrahepatic biliary duct from one or more calculi within the cystic duct or gallbladder.