DOI: 10.36347/sjmcr.2020.v08i12.002

Pages: 992-993

Mirizzi syndrome is a rare condition caused by the obstruction of the common bile duct or common hepatic duct and without preoperative diagnosis mortality could be as high as 17%. It has been reported that 6% to 28% of patients with preoperative diagnosis of Mirizzi syndrome actually had gallbladder cancer. The disease can mimic cancer of the gallbladder, causing considerable diagnostic difficulties. In this current case A 22-year-old well gentleman presented with 4 days history of yellowish discoloration to eyes, skin, abdominal pain on eating food and weight loss of 10 kgs over past 6 months. Icterus was note on examination. He was referred to secondary care for further evaluation. Blood test confirmed deranged Liver function tests. MRCP showed – Stones of the Extrahepatic bile ducts causing intrahepatic bile duct obstruction, probably located within the lower end of the anomalously crossing cystic duct causing extrinsic compression of the common duct (Merizzi Syndrome). A Laparoscopic Cholecystectomy + Trans cystic CBD exploration with Choledochoscope and extraction of stones by Dormia basket + Intraoperative Cholangiogram (IOC) was carried out. Findings were in keeping with Mirizzi syndrome. Blood tests done post operatively showed improvement in bilirubin and LFTs in span of 20 days. He was discharged home on oral antibiotics and analgesia. Mirizzi’s syndrome is a rare complication caused by gallstone(s) located in the infundibulum of the gallbladder or cystic duct leading to adjacent biliary duct compression which results in partial or complete obstruction of the common hepatic duct and sometimes with the presence of cholecystocholedochal fistula. Incidence ranges from 1% per year in developed countries to upto 5.7% in developing countries. Surgical cholecystectomy is considered as the treatment of choice [3]. The surgeon is the main specialist for diagnosis and treatment but familiarity and a high degree of suspicion of this condition must be present by......