Biliary imaging: Mirizzi syndrome: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Biliary imaging: Mirizzi syndrome

Sample item

A patient with long-standing gallstones has jaundice. Imaging shows a stone impacted in the gallbladder neck or cystic duct that compresses the common hepatic duct, with intrahepatic ductal dilatation above it. What is this syndrome?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Mirizzi syndrome

In Mirizzi syndrome, an impacted stone in Hartmann pouch or the cystic duct extrinsically narrows the common hepatic duct, causing obstructive jaundice. It may erode into the duct and form a fistula.

Option by option

  • A. Mirizzi syndrome (correct)

    Correct. External compression of the hepatic duct by an impacted cystic duct stone is Mirizzi syndrome.

  • B. Gallstone ileus

    Gallstone ileus is small bowel obstruction by a stone passed through a fistula.

  • C. Courvoisier sign

    Courvoisier sign is a palpable distended gallbladder with painless jaundice from a malignancy.

  • D. Bouveret syndrome

    Bouveret syndrome is gastric outlet obstruction by a duodenal stone.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is A, Mirizzi syndrome. In Mirizzi syndrome, an impacted stone in Hartmann pouch or the cystic duct extrinsically narrows the common hepatic duct, causing obstructive jaundice.

Why is "Gallstone ileus" not the answer?

Gallstone ileus is small bowel obstruction by a stone passed through a fistula.

Why is "Courvoisier sign" not the answer?

Courvoisier sign is a palpable distended gallbladder with painless jaundice from a malignancy.

Why is "Bouveret syndrome" not the answer?

Bouveret syndrome is gastric outlet obstruction by a duodenal stone.

What concept does this question test?

It tests Biliary imaging: Mirizzi syndrome in Radiology. It may erode into the duct and form a fistula.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Biliary imaging: Mirizzi syndrome?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.