[Mirizzi syndrome type II with a gastric antrum erosion: an atypical presentation]

The Mirizzi's syndrome is an unusual complication of long-standing gallstone disease that occurs in 0.7% to 1.4% of all cholecystectomies performed. It was originally described as an obstruction of the proximal bile duct secondary to external compression by a large stone located in the Hartmann pouch or secondary to local inflammatory changes. In recent years, extension of Mirizzi's eponym has been used to define obstructive jaundice induced by different grades of compression and erosion of the bile duct wall by a stone, which can evolve to a complete cholecystocholedocal fistula, with compression and dilatation of the proximal bile duct by the stone. Herein we present a case of Mirizzi's syndrome type II with a gastric antrum erosion associated, in highlighting the essential of the pre-operative diagnosis by endoscopic retrograde cholangiography (ERC) or MR cholangiography, to avoid iatrogenic injuries of the bile ducts, because the syndrome has been cited as a trap in the surgery gallstones. This case is an example that the natural history of Mirizzi's syndrome cannot stop with the compression or the cholecysto-biliary fistula, but it may result in a complex fistula with the neighbouring digestive organs.