14 August 2022
: Case report 
Unusual Case of Mirizzi Syndrome Presenting as Painless Jaundice
Unusual clinical course, Challenging differential diagnosis
Justin Bauzon1ABCDEFG*, Sarah Haller1ABEF, Jose R. Aponte-Pieras2ABCDEF, Daisy Lankarani2BCDEF, Ariyon Schreiber
3ABEF, Nazanin Houshmand3ABEF, Shahid Wahid2ADEFG
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 <1/3 of anterior or lateral CBD wall | 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. | |||||