Related Experiment Video
Updated: May 30, 2026

Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
Published on: July 5, 2021
[A patient with a possible Mirizzi's syndrome]
Maarten G Niebling1, Marinus Eeftinck Schattenkerk, Mike S L Liem
1Deventer Ziekenhuis, afd. Heelkunde, Deventer, the Netherlands. maartengjn@hotmail.com
Background:
Mirizzi's syndrome is a rare cause of jaundice. The syndrome refers to common hepatic duct obstruction or choledoch duct obstruction caused by extrinsic compression of an impacted stone in the gallbladder neck or cystic duct.
Case Description:
A 42-year-old woman was referred to the emergency department with symptoms indicative of obstructive icterus. Endoscopic retrograde cholangiopancreatography (ERCP) and a CT scan revealed signs of Mirizzi's syndrome but no indications of malignancy. Laparoscopic cholecystectomy was decided upon. This procedure revealed that the obstruction was caused by a gallbladder carcinoma.
Conclusion:
Of those patients suspected of having Mirizzi's syndrome, retrospectively 5-28% prove to have carcinoma of the gallbladder. Therefore in Mirizzi's syndrome before carrying out laparoscopic cholecystectomy a careful diagnostic approach is essential. This includes ERCP or MRI cholangiopancreaticography (MRCP) and a CT scan. Even after these investigations the surgeon should only perform laparoscopic surgery with caution, as it is often converted to an open procedure and because of the risk of presence of a malignancy.
Related Concept Videos
Mitral Stenosis II: Clinical features and Diagnostic Tests
Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are:
Toxidromes: Clinical Features
Aneurysm II: Clinical Manifestations and Diagnostic Studies
Cytomegalovirus Disease
Chronic Obstructive Pulmonary Disease IV: Clinical Manifestations