A rare case of Mirizzi syndrome due to pure calcium carbonate stones (Limy Bile). | [Journal of Pakistan Medical Association • 2016]

Author(s):

1. Nooman Gilani: South Medical Ward, Mayo Hospital/King Edward Medical University, Lahore, Pakistan

2. Muhammad Farooq Hanif: South Medical Ward, Mayo Hospital/King Edward Medical University, Lahore, Pakistan

3. Veronika Karasek: Department of Gastroenterology and Hepatology, Phoenix VA HealthcareSystem/Universityof Arizona, Phoenix, AZ, USA

Abstract:

We report the first case of Mirizzi syndrome in a patient who presented with biliary obstruction caused by pure calcium carbonate stones. A 61 years old male with history of portal vein thrombosis presented with rash, nausea and jaundice. An ultrasound of biliary tree showed gallstones with dilatation of hepatic duct and intrahepatic biliary tree. There was suspicion of a stone in proximal CBD. CT scan showed an opaque gallbladder with dense radio-opaque material in its lumen. An ERCP was then performed revealing external common hepatic duct obstruction at the neck of the gallbladder. A plastic biliary stent was placed across the obstruction, followed by a cholecystectomy. Resected gallbladder specimen revealed thick whitish paste like material, and formed stones filling the gallbladder lumen. Laboratory testing showed this material to be composed of 100% calcium carbonate crystals.

Page(s): 751-753

DOI: DOI not available

Published: Journal: Journal of Pakistan Medical Association, Volume: 66, Issue: 6, Year: 2016

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