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Mirizzi syndrome — ESEGH MCQ

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HardPancreatico-biliary DiseaseMirizzi syndromeESEGH

A 52-year-old woman has intermittent jaundice and right upper quadrant pain. MRCP shows extrinsic compression of the common hepatic duct by a stone impacted in the gallbladder neck. There is no pancreatic mass. What is the most likely diagnosis?

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Correct answer: E — Mirizzi syndrome

The best answer is “Mirizzi syndrome”. A gallbladder-neck stone compressing the common hepatic duct produces the characteristic obstructive pattern of Mirizzi syndrome. The alternatives “Primary biliary cholangitis”, “Gallbladder adenomyomatosis”, “Autoimmune pancreatitis”, “Sphincter of Oddi dysfunction” are plausible in related gastroenterology presentations but do not match the defining finding, threshold, sequence or UK pathway in this stem.

Reference: NICE NG85 pancreatic cancer recommendations: https://www.nice.org.uk/guidance/ng85/chapter/Recommendations