Biliary stent insertion during endoscopic retrograde cholangiopancreatography is used as a therapeutic intervention allowing flow of bile into the duodenum. In rare circumstances, distal gastrointestinal perforation can be attributed to a migrated biliary stent, with the most common site being the sigmoid colon. In these cases, surgical and/or endoscopic intervention may be required. We report a case of a 98-year-old male presenting with small bowel obstruction secondary to migrated plastic and metal biliary stents placed for acute biliary pancreatitis. Due to advanced age and high-risk multiple comorbidities, conservative management was undertaken. The patient was discharged after 5 days after ongoing pain and obstipation with palliative care services in place.
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