TITLE:
Duodenal Perforation Caused by Distal Migration of Biliary Stent
AUTHORS:
Benjamin Y. M. Tan, George P. C. Yang
KEYWORDS:
Cholangiopancreatography, Endoscopic Retrograde, Cholangitis, Intestinal Perforation
JOURNAL NAME:
Case Reports in Clinical Medicine,
Vol.5 No.4,
April
26,
2016
ABSTRACT: Background: Migration of endoscopically placed biliary stents is a known complication of endoscopic retrograde cholangiopancreatography, which has a reported incidence of 3% - 6%. Usually, distal migration is asymptomatic and is detected incidentally. Case Presentation: We present a rare case of duodenal perforation caused by distal migration of a biliary stent. A 50 years old gentleman initially presented with cholangitis. ERCP showed a dilated common bile duct with a 9 mm stone and a biliary stent was placed. The patient subsequently presented with biliary peritonitis due to the migration of the stent causing perforation of the anterior wall of the second part of the duodenum. Emergency laparotomy was performed to remove the stent and the perforation was repaired. The patient made an uneventful recovery. Discussion: A brief discussion on stent migration is also conducted. Whilst distal migration of stents is less common than its proximal counterpart, it is important to note that rare complications may arise and be addressed in a timely manner.