Concurrent Mirizzi syndrome and choledocholithiasis: imaging features and surgical correlation

We describe a case of concurrent Mirizzi syndrome and choledocholithiasis in a woman in her mid-60s. The abnormalities were first identified on abdominal ultrasound and subsequently confirmed with contrast-enhanced computed tomography (CECT) and magnetic resonance cholangiopancreatography (MRCP). Imaging demonstrated extrinsic compression of the common hepatic duct (CHD) by an impacted gallstone at the cystic duct along with concomitant calculi in the distal common bile duct (CBD). The patient underwent open cholecystectomy with CBD exploration, choledochoscopy, and choledochoduodenostomy. This case emphasizes the essential role of cross-sectional imaging in detecting coexisting biliary pathologies and facilitating accurate preoperative diagnosis, which is essential for optimal surgical planning and improved patient outcomes.