A Case of Mirizzi Syndrome with Pancreatic Divisum: A rare association

Abstract

Mirizzi syndrome (MS), a rare complication of gallstones, refers to extrahepatic biliary compression by calculus in the cystic duct or Hartman’s pouch and is usually associated with cystic duct abnormalities. Its association with pancreatic divisum(PD) is infrequent, the most common complication of PD being recurrent pancreatitis. We report a case of 39-year-old female who presented with acute abdominal pain to the department of general surgery, Chennai, Tamil Nadu, India in August 2022. Magnetic resonance cholangiopancreaticography (MRCP) showed calculous cholecystitis with a calculus indenting the cystic duct, causing luminal narrowing of the common hepatic duct (type I), which was associated with type II PD. The association of MS with PD has been rarely described. PD may be one of the factors responsible for bile stasis leading to calculous cholecystitis and its complications. Knowledge of MS and its associations helps in early diagnosis and selection of appropriate treatment management.