Presentation
Pregnant lady about 26 weeks, presented to the emergency department complaining of right upper quadrant pain, positive Murphy sign, and jaundice. Liver function test (LFT) revealed high total bilirubin.
Patient Data
Increased liver size measuring about 19.4 cm. Diffuse intrahepatic biliary radicals dilatation.
Dilated common hepatic duct measuring about 8.6 mm.
Distended gallbladder (GB) with normal wall thickness, mild intraluminal biliary sludge and about 1.6 cm stone at the GB neck.
Gravid uterus with single fetus.
Increased liver size measuring about 19.5 cm. Diffuse intrahepatic biliary radicals dilatation (axial T2, coronal T2, T2 3D).
Dilated common hepatic duct (CHD) measuring about 1.4 cm.
Distended GB with about 1.6 cm stone at GB neck. Significantly distended cystic duct (coronal T2, axial T2, T2 3D) measuring about 1.8 cm at maximum diameter with about 1.3 cm stone impacted at its distal end (coronal T2, axial T2, T2 3D) causing compression and tapering of distal common hepatic duct (CHD). Normal caliber common bile duct (CBD).
Case Discussion
Mirizzi syndrome is a rare condition where a gallstone becomes lodged in the cystic duct or neck of the gallbladder, causing compression of the common hepatic duct. This leads to obstructive jaundice.
The radiological features are consistent with Mirizzi syndrome, which was confirmed at open cholecystectomy and was done after a failed trial of extraction of the impacted stone at distal cystic duct by ERCP.
Unable to process the form. Check for errors and try again.