An Unusual Complication of Gallstones: Mirizzi Syndrome - A Case Report and Literature Review

Abstract

1 Department of Medicine, Capital Development Authority (CDA) Hospital, Islamabad, Pakistan 2 Department of Medicine, Capital Development Authority (CDA) Hospital, Islamabad, Pakistan 3 Department of Medicine, Capital Development Authority (CDA) Hospital, Islamabad, Pakistan Corresponding Author Adnan Bashir Bhatti, MD Email: dr.adnanbashir@gmail.com Abstract Mirizzi syndrome is a rare complication of gallstone disease, causing major biliary problems, if the diagnosis is not made early. This condition was also reported to occur in the setting of acute acalculous cholecystitis. It was first described in 1948 by Pablo Mirizzi and presented itself in the form of unusually lodged gallstone in either the cystic duct or most frequently in Hartmann pouch of the gallbladder. We report a 50-year-old female with exquisite pain in right hypochondrium and epigastrium with nausea and vomiting for the last 20 days. She also had yellowish discoloration of urine, clay-colored stools, and tender right hypochondrium. Laboratory investigations revealed raised liver enzymes and ultrasonography (USG) was inconclusive in describing an impacted stone in the gallbladder neck. Computerized tomography (CT) scan and magnetic resonance cholangiopancreatography (MRCP) revealed it as suspected case of a mirizzi syndrome which was later confirmed by surgery. The patient was recovered after surgery without complications.