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Corresponding author: Rabih M. Salloum, MD, Department of Surgery, University of Rochester School of Medicine, Box SURG, Rochester, NY 14642 (e-mail: Rabih_Salloum{at}urmc.rochester.edu).

Arch Surg. 2004;139:450.

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Answer: Mirizzi Syndrome

Figure 1. Computed tomographic scan of the abdomen.

Figure appears in full text version. Figure 1.

Figure 2. Classification of Mirizzi syndrome.

Figure appears in full text version. Figure 2.

The CT scan of the abdomen revealed a large complex cystic mass 13 x 12 x 10 cm in the area of the porta hepatis and gallbladder fossa (Figure 1A, B, and C). At closer inspection, the mass was displacing the duodenum and pancreatic head to the left, and a clear plane between the mass and pancreatic head was visible (Figure 1D). Biliary ductal dilatation was also visible, and a normal portal vein was seen (Figure 1D, arrow).

The patient underwent exploratory laparotomy through a right subcostal incision. Findings at the time of surgery were a large cyst of the gallbladder with multiple stones and copious sludge. An intraoperative cholangiogram demonstrated normal biliary anatomy, and cholecystectomy was performed. The patient had an uneventful postoperative . . . [Full Text of this Article]

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Arch Surg. 2004;139(4):449.
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