Mirizzi syndrome with choledocholithiasis

Case contributed by Joe Mullineux


Jaundice and RUQ pain. History of gallstones.

Patient Data

Age: 70 years
Gender: Female

Coronal and axial T2 weighted images selected from MRCP study showing a large gallstone wedged in the neck of the gallbladder causing extrinsic compression of the common hepatic duct and resulting in marked intra-hepatic duct dilatation.

Further small gallstones noted in the distal part of common bile duct.

Incidental findings: left renal cyst, degenerative spinal changes and wedge compression L2.

Case Discussion

Classic case of Mirizzi syndrome. Additionally, this case shows multiple CBD stones (choledocholithiasis) an important finding for the surgeon to know prior to considering cholecystectomy and important not to overlook (potential "satisfaction of search" error).

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