Unusual Case of Mirizzi Syndrome Presenting as Painless Jaundice

14 August 2022: Articles

Unusual clinical course, Challenging differential diagnosis

Justin Bauzon ^A* , Sarah Haller ^A , Jose R. Aponte-Pieras ^A , Daisy Lankarani ^B , Ariyon Schreiber ^A , Nazanin Houshmand ^A , Shahid Wahid ^A

DOI: 10.12659/AJCR.936836

Am J Case Rep 2022; 23:e936836

Table 2. Classification, descriptions and management of Mirizzi syndrome subtypes.

	Type I	Type II	Type III	Type IV	Type V
Description	Impacted stone at cystic duct or gallbladder neck	Stone erodes	Fistula eroding 1/3 to 2/3 of CBD circumference	Fistula completely involves/obliterates CBD wall	Cholecystoenteric fistula + any type ± gallstone ileus
Cholecystobiliary fistula presence	No	Yes	Yes	Yes	Yes and no
Management	Partial or total cholecystectomy; CBD exploration not typically required	Cholecystectomy plus fistula closure (suture, T-tube or choledochoplasty)	Choledochoplasty or bilioenteric anastomosis depending on fistula	Bilioenteric anastomosis (typically choledocho-jejunostomy)	Cholecystectomy with excision of fistula
CBD – common bile duct.