A 40-year-old male patient with a history of Mirizzi’s Syndrome presented for bile duct stent removal. He presented 6 weeks prior with obstructive jaundice and ascending cholangitis. The patient is a nursing home resident with HIV on antiretroviral therapy, and has suffered from seizures and stroke. ERCP showed markedly dilated intrahepatic bile ducts and common hepatic duct with an
unremarkable lower common bile duct (CBD) (Figure 1). During attempted balloon sweep with a 12mm balloon, resistance was felt in the mid CBD region and Mirizzi’sSyndrome was suspected. An 11.5Fr by 9cm Flexima™ Biliary Plastic Stent was placed (Figure 2). Pus and dark bile flowed through the stent.