An Unusual Case of Mirizzi Syndrome With Double Spontaneous Gallbladder Fistulas With the Colon and the Duodenum Presenting As Acute Cholecystitis

Abstract

The Mirizzi syndrome is amongst the rarest complications of long-standing gallstone disease. It is an even rarer occurrence when concurrent with a cholecystoenteric or cholecystoduodenal fistula and might not include an accompanying gallstone ileus. Chronic cholecystitis is the primary etiology, but pre-operative diagnosis is challenging due to its non-specific symptoms compared with acute cholecystitis. In this unusual case, the patient has a Csendes type Va Mirizzi syndrome associated with a double cholecystoduodenal and cholecystocolonic fistula, a rare presentation.