Mirizzi syndrome with choledocholithiasis
Jaundice and RUQ pain. History of gallstones.
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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 common bile duct.
Incidental findings: left renal cyst, degenerative spinal changes and wedge compression L2.
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).