Fact-sheet: Mirizzi syndrome
Updated on 04/19/2018 at 4:27 PM
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Definition
Extrinsic compression of the common bile duct reactive to impaction of a gallstone in the cystic duct or gallbladder neck.
This is always associated with acute cholecystitis.
Clinical features
Signs of acute cholangitis:
febrile biliary colic,
jaundice of skin and mucous membranes
Associated with signs of acute cholecystitis:
inspiratory arrest on deep breathing (Murphy's sign),
right upper quadrant guarding
Laboratory findings
Biological inflammatory syndrome.
Marked cholestasis.
Ultrasound
Dilation of the intrahepatic bile ducts and common bile duct upstream from the compression caused by the stone impacted in the cystic duct or gallbladder neck.
Intrapancreatic common bile duct of normal caliber.
CT
- Lithiasic, distended, and inflammatory gallbladder.
- Stone impacted in the gallbladder neck or cystic duct causing compression of the right border of the common bile duct.
- Upstream dilation of the intrahepatic bile ducts.
- Intrapancreatic common bile duct (downstream from the compression) not dilated.
Differential diagnosis
Acute cholangitis due to lithiasis, lymphadenopathy, or tumoral lesion.