RT Journal Article
SR Electronic
T1 A large choledochocystolithiasis mimicking Mirizzi syndrome
JF BMJ Case Reports
FD BMJ Publishing Group Ltd
SP bcr-2017-219582
DO 10.1136/bcr-2017-219582
VO 2017
A1 Chaudhry, Mustafa Belal Hafeez
A1 Azeemuddin, Muhammad
A1 Khan, Muhammad Rizwan
A1 Parkash, Om
YR 2017
UL http://casereports.bmj.com/content/2017/bcr-2017-219582.abstract
AB An 18-year-old man presented with spontaneous severe epigastric pain, progressing and radiating to back since 3 days. It was associated with epigastric tenderness, bilious vomiting and jaundice. He had been intermittently experiencing these symptoms for the last 1 year. No known comorbid. Ultrasound showed a poorly visualised heterogeneous focus at porta hepatis; considering poor visualisation, this might represent an enlarged calcified lymph node or cystic duct calculus causing extrinsic compression or a large sludge ball within the common bile duct (CBD), leading to dilatation of common hepatic duct and intrahepatic biliary system. Subsequent magnetic resonance cholangiopancreatography revealed a focal saccular dilatation of middle part of CBD, a type I-B choledochal cyst, large heterogeneous focus seen within it representing choledochocystolithiasis. Later, CT was performed for further characterisation of surrounding anatomy and pathology, which confused the appearance of choledochocystolithiasis for Mirizzi syndrome. Later, surgery and histopathology confirmed type I-B choledochocystolithiasis and chronic cholecystitis.