A big choledochocystolithiasis mimicking Mirizzi syndrome.
BMJ Case Rep. 2017 Jun 24;2017:
Authors: Chaudhry MBH, Azeemuddin M, Khan MR, Parkash O
An 18-year-old man introduced with spontaneous extreme epigastric ache, progressing and radiating to again since three days. It was related to epigastric tenderness, bilious vomiting and jaundice. He had been intermittently experiencing these signs for the final 1?12 months. No recognized comorbid. Ultrasound confirmed a poorly visualised heterogeneous focus at porta hepatis; contemplating poor visualisation, this would possibly characterize an enlarged calcified lymph node or cystic duct calculus inflicting extrinsic compression or a big sludge ball inside the widespread bile duct (CBD), resulting in dilatation of widespread hepatic duct and intrahepatic biliary system. Subsequent magnetic resonance cholangiopancreatography revealed a focal saccular dilatation of center a part of CBD, a sort I-B choledochal cyst, giant heterogeneous focus seen inside it representing choledochocystolithiasis. Later, CT was carried out for additional characterisation of surrounding anatomy and pathology, which confused the looks of choledochocystolithiasis for Mirizzi syndrome. Later, surgical procedure and histopathology confirmed kind I-B choledochocystolithiasis and persistent cholecystitis.
PMID: 28647717 [PubMed – indexed for MEDLINE]