Acute acalculous cholecystitis complicated by MRCP-confirmed Mirizzi syndrome: A case report

Abstract

INTRODUCTIONAcute acalculous cholecystitis can be complicated by extrinsic compression of the common hepatic/common bile duct by the enlarged and inflamed gallbladder followed by jaundice. Its mechanism is very similar to that of Mirizzi syndrome, when the bile duct is compressed from outside due to a stone impacted in the gallbladder neck or cystic duct. This complication of acalculous cholecystitis is rare, with very little number of published cases. PRESENTATION OF A CASEWe present a patient with compression of the common hepatic duct by an inflamed and enlarged gallbladder in the absence of stones as confirmed by magnetic resonance cholangiopancreatography (MRCP). Acute cholecystitis and jaundice resolved after conservative treatment, and the changes were shown by a follow-up MRCP five months later. DISCUSSIONWe were able to find only three similar cases reported in the literature. In these cases, compression of the common hepatic/common bile duct by the inflamed gallbladder was confirmed by endoscopic retrograde cholangiopancreatography and intraoperatively. Terminology to describe this condition has not been agreed upon. We consider it as a special kind of Mirizzi syndrome. CONCLUSIONTo the best of our knowledge, this is the first reported case of MRCP-confirmed Mirizzi syndrome in acute acalculous cholecystitis.