After surgical removal of the organ shown below, the specimen is opened on the operating room table. Based on what you see, what one specific presentation is associated with this pathology?
A. Acute cholecystitis
E. Gallstone ileus
Mirizzi’s syndrome is a rare complication in which a gallstone becomes impacted in the cystic duct or neck of the gallbladder causing compression of the common hepatic duct, resulting in obstruction and jaundice. From the image you can see that there is external compression of the common bile duct
Surgery is extremely difficult as Calot’s triangle is often completely obliterated and the risks of causing injury to the CBD are high.
Multiple and large gallstones can become impacted in the Hartmann’s pouch of the gallbladder, leading to chronic inflammation—which leads to compression of the common bile duct (CBD), necrosis, fibrosis, and ultimately fistula formation into the adjacent common hepatic duct (CHD) or common bile duct (CBD).