Duodenum and ascending colonal perforation due to biliary stent migration

Introduction: Bowel perforation due to migrated biliary stent is a rare complication. Here, we report a case of duodenal and ascending colonal perforation due to biliary stent migration.

Case presentation: A 35-year-old man is complaining of right upper abdominal pain presented to the gastroenterology department. Two months ago, he was diagnosed with common bile duct stone with acute cholangitis, a straight plastic biliary stent was placed in his common bile duct. Abdominal computed tomography, upper endoscopy and colonoscopy confirmed that the stent penetrated the duodenum into the ascending colon. The stent was extracted by upper endoscopy, and the defects of the duodenum and ascending colon were closed by clips endoscopically.

Discussion: Bowel perforation due to biliary stent migration is a rare but severe complication. Risk factors for dislocation of stents include stent insertion for more than one month, wide stent, benigh diseases and longer stent. Endoscopy is a minimally invasive and safe meneuver to retrieve stent.

Conclusion: Patients inserted with long, wide and straight biliary stent for more than one month are at high risk of stent dislocation. Endoscopy is a minimally invasive and safe meneuver to retrieve stent, and should be considered as the first-line treatment.