Mirizzi syndrome type V complicated with both cholecystobili
Mirizzi syndrome (MS) is a common bile duct (CBD) obstruction caused by extrinsic compression from an impacted stone in the cystic duct or infundibulum of the gallbladder. Patients affected by MS may present abdominal pain and jaundice.

A 37-year-old male with neurologic residuals post-encephalitis arrived at the emergency department reporting abdominal pain, jaundice, and fever. An ultrasound of the abdomen identified cholecystolithiasis with a dilated CBD. He did not undergo CT or MRI due to poor compliance and parents’ disagreement.

Eventually, they accepted to perform endoscopic retrograde cholangiopancreatography, which diagnosed MS with both cholecystobiliary and cholecystocolonic fistula without gallstone ileum (type Va).

Therefore, the patient underwent cholecystectomy, wedge resection of the colon, and choledochoplasty with ‘Kehr's T-tube’ insertion. A plastic biliary stent was successively placed and removed after 4 months. Ultimately, he did neither complain of any other biliary symptoms nor alteration in laboratory tests after 4-years of follow-up.

Journal of Surgical Case Reports
Source: https://doi.org/10.1093/jscr/rjab239