Mirizzi's syndrome pathophysiology

Mirizzi's syndrome Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Pathophysiology

Multiple and large gallstones can reside chronically in the Hartmann's pouch of the gallbladder, causing inflammation, necrosis, scarring and ultimately fistula formation into the adjacent common bile duct (CBD). As a result, the CBD becomes obstructed by either scar or stone, resulting in jaundice. It can be divided into four types. Type I does not involve a fistula at all. Types II- IV involve fistulas of different sizes.

Type II is classified as a fistula of <33% of the CBD width. Type III Mirizzi Syndrome involves a fistula between 33% and 66% of the CBD width. Type IV involves a fistula of greater than 66% of the CBD width.