Ario Perbowo *, Dadang Makmun **

* Department of Internal Medicine, Faculty of Medicine, University of Indonesia Dr. Cipto Mangunkusumo General National Hospital, Jakarta

** Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia/Dr. Cipto Mangunkusumo General National Hospital, Jakarta

ABSTRACT

Mirizzi syndrome is a rare complication of gallstone which is characterized by the presence of gallstone impaction in cystyc duct that leads to inflammatory stricture in the biliary duct and results in obstructive jaundice. In this report, we highlighted the diagnostic approach and management of Mirizzi syndrome in a 58 year-old male complaining of nausea, vomiting and appearing jaundice.

The role of imaging such as abdominal ultrasonography in depicting the characteristic of Mirizzi syndrome was also discussed and compared the findings with classification of the disease in the litarature. In this patient, Mirizzi syndrome was suspected by the appearance acoustic shadow in the gallbladder with dilated cystyc duct suggesting the impaction of common bile duct (CBD). we performed endoscopic retrograde cholangiopancreatography (ERCP) as both diagnostic and therapeutic modalities by which we allowed sphingterectomy to evacuate the gallstone. However, due to the risk of further stone evacuation, the procedure was followed by elective cholectstectomy.

Keywords:  gallstone, Mirizzi syndrome, complication

Indones J Gastroenterol Hepatol Dig Endosc Vol.15, No.2, August 2014 (FULL TEXT)