Mirizzi syndrome: a challenging diagnosis. Case report.

Mirizzi Syndrome (MS) is an uncommon complication of chronic gallstone disease defined as a common bile duct (CBD) obstruction secondary to gallstone impaction in the cystic duct or gallbladder neck. MS is still a challenging clinical situation: preoperative diagnosis of MS is complex and can be made in 18-62.5% of patients. Over 50% of patients with MS is diagnosed during surgery. In most of cases, laparotomy is the preferred surgical approach. We report the case of a 70-year-old woman with a history of asthenia, jaundice, abdominal pain and preoperative imaging that suggest the presence of biliary stones with a choledocal stenosis. Intraoperatively, a MS with cholecysto-biliary fistula involving less than two-thirds of the circumference of the bile duct was diagnosed and successfully treated.