Mirizzi syndrome is a rarely observed complication of gallstone disease, caus. It was described in 1948 by P.L Mirizzi and presents unusual lodged gallstone in either the cystic duct or most frequently in Hartmann pouch oj the gallbladder. Impaction, acute obstruction and wall ischemia are causative for inflammation and abscess formation. External common hepatic bile duct compression and obstruction result in clinical presentation of intermittent or constant jaundice. The authors report 50 year old male with extensive mechanical pain in the upper right quandrant and jaundice. Abdominal US and CT image showed gallstone in CBD 1.5 cm, ERCP revealed stone or cholangioma in CBD, Mirizzi syndrome was diagnosed after operation. Intraoperatively was found an impacted gallstone in the Hartmann pounch, extensive fibrosis of hepatoduodenal ligament with engagement of common hepatic bile duct wall. Antegrade cholecystectomy and Roux-Y limb anastomosis was performed after unsuccessful tentative for recanalization of distal CBD with clamping of drain.
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