PMC7306538_01
CT scan showing distended gallbladder with an impacted stone in neck/cystic duct.
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CT scan abdomen and pelvis showed a distended gallbladder with a large stone in neck/cystic duct (Fig. 1, Fig. 2).
ERCP unable to visualize cystic duct.
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Large cystic duct stone was seen which could not be retrieved (Fig. 3).
MRCP showing Mirizzi type I.
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MRCP was done which showed Mirizzi's syndrome type I based on the finding of significantly distended gallbladder due to impacted 3.2 x 2.2 cm stone in gallbladder neck/cystic duct with extrinsic compression of common hepatic duct (Fig. 4).
Empyema gallbladder, per-operatively.
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Patient was taken to operating room for cholecystectomy but preoperatively a huge empyema (Fig. 5) was encountered with a necrotic posterior gallbladder wall. 30cc of pus was aspirated from the gallbladder (Fig. 6).
Aspiration of pus from gallbladder.
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Patient was taken to operating room for cholecystectomy but preoperatively a huge empyema (Fig. 5) was encountered with a necrotic posterior gallbladder wall. 30cc of pus was aspirated from the gallbladder (Fig. 6).
Stone impacted at neck of gallbladder (white arrow).
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A large stone impacted in the neck of gallbladder was located and extracted (Fig. 7).