Presentation
Pain in abdomen, vomiting, backache, and generalized weakness.
Patient Data
The gall bladder lumen appears well-distended and shows edematous wall with few calculi in the fundus and the cystic duct, the largest in the cystic duct measuring 9 x 6 mm. Cystic duct impacted calculus is seen compressing common hepatic duct. The common bile duct is normal in caliber with no evidence of calculi. The proximal common hepatic duct, right and left hepatic ducts, and central intrahepatic biliary radicles are dilated.
Features suggestive of cholelithiasis with acute cholecystitis. Cystic duct calculus is seen compressing the common hepatic duct with upstream dilatation of right and left hepatic duct and central intrahepatic biliary radicles suggesting 'Mirizzi syndrome'.
Case Discussion
Impacted stones in the gallbladder or cystic duct result in inflammation of the gallbladder wall with compression of the common hepatic or bile duct, causing obstructive jaundice. In our case, an impacted cystic duct calculus is seen compressing the common hepatic duct.
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