Mirizzi's syndrome natural history, complications and prognosis

Natural History

• Mirizzi syndrome frequently presents in an acute form. However, chronic form is equally common or an even more common form of presentation.
• Clinical presentation of Mirizzi’s syndrome could be non-specific.
• However, it presents most commonly with obstructive jaundice (60%-100%), accompanied by right upper quadrant abdominal pain (50%-100%) and fever. ^[1]
• Patient may be a known or suspected case of gallstone disease.
• Previous history of jaundice is sometimes present.
• Patients frequently present in the setting of acute cholecystitis, acute cholangitis, acute pancreatitis or gallstone ileus.

Complications

• Cholecystocholedochal fistula
• Cholecystoenteric fistula
• Cutaneous fistulas.
• Secondary biliary cirrhosis.
• Delayed onset biliary strictures.
• Operative and postoperative morbidity and mortality (according to the severity of lesion).

Prognosis

• Severe inflammation and delayed or missed diagnosis may result in high morbidity and mortality. Surgical management is the mainstay treatment. ^[2]