Abstract

 Acute inflammation of the gallbladder can occur without gallstones. Acalculous cholecystitis typically develops in critically ill patients in the intensive care unit. Patients on parenteral nutrition, with extensive burns, sepsis, major operations, multiple organ trauma or prolonged illness with multiple organ system failure are at risk for developing acalculous cholecystitis. The association of acalculous cholecystitis with Mirizzi syndrome is very unusual. Mirrizzi syndrome, which is an unusual cause of obstructive jaundice, is most commonly caused by a stone impacted in Hartmann’s pouch, exerting pressure over the common bile duct (CBD) with subsequent erosion into the CBD. The case we are presenting is a case of Mirrizi syndrome type-1 due to acalculous cholecystitis in a 13- year-old girl that presented with intermittent jaundice and RUQ abdominal pain and fever. Intraoperative finding showed Mirizzi syndrome type- 1 without gallstones. The cause of jaundice was only pressure of the gallbladder on the CBD and cholecystectomy with intraoperative cholangiography was performed. At post operative follow-up, the patient became anicteric and all symptoms and signs disappeared.