Mirizzi syndrome associated with liver atrophy. Diagnostic and management considerations

It is not often appreciated that the Mirizzi syndrome represents a spectrum of pathological lesions of the proximal extrahepatic biliary tree consequent on chronic gallbladder disease. A patient with this syndrome and associated liver atrophy is presented, emphasising the view that the syndrome has neither uniform appearance nor typical features and that a high index of suspicion and comprehensive investigations are required for diagnosis and optimal therapy.