# A Case of Mirizzi Syndrome with Pancreatic Divisum: A rare association

## TL;DR

A rare case of Mirizzi syndrome combined with pancreatic divisum is reported, highlighting the importance of recognizing such associations for proper diagnosis and treatment.

## Contribution

This paper presents a rare clinical association between Mirizzi syndrome and pancreatic divisum, contributing to the understanding of their potential interplay.

## Key findings

- A 39-year-old female was diagnosed with Mirizzi syndrome type I and pancreatic divisum type II.
- The association of pancreatic divisum may contribute to bile stasis and complications like calculous cholecystitis.
- Early recognition of such rare associations can improve diagnostic accuracy and treatment outcomes.

## Abstract

Mirizzi syndrome (MS), a rare complication of gallstones, refers to extrahepatic biliary compression by calculus in the cystic duct or Hartman's pouch and is usually associated with cystic duct abnormalities. Its association with pancreatic divisum (PD) is infrequent, the most common complication of PD being recurrent pancreatitis. We report a 39-year-old female patient who presented to a department of general surgery in Chennai, India, in 2022 with acute abdominal pain. Magnetic resonance cholangiopancreaticography (MRCP) showed calculous cholecystitis with a calculus indenting the cystic duct, causing luminal narrowing of the common hepatic duct (type I), which was associated with type II PD. The association of MS with PD has been rarely described. PD may be one of the factors responsible for bile stasis leading to calculous cholecystitis and its complications. Knowledge of MS and its associations helps in early diagnosis and selection of appropriate treatment management.