A Rare Complication of Biliary Stent Migration: Small Bowel Perforation in a Patient with Incisional Hernia

Abstract

Endoscopic biliary stents have been recently applied with increasing frequency as a palliative and curable method in several benign and malignant diseases. As a reminder, although most of the migrated stents pass through the intestinal tract without symptoms, a small portion can lead to complications. Herein, we present a case of intestinal perforation caused by a biliary stent in the hernia of a patient with a rarely encountered incarcerated incisional hernia.

Appendiceal perforation due to biliary stent migration in a neutropenic patient with lung cancer receiving chemotherapy: A case report

“…Sporadic cases of small-or large-bowel perforation have been reported (7,8). Interestingly, such perforations have occurred in conjunction with a separate predisposing factor such as diverticula, adhesions, or incarcerated bowel in an incisional hernia (7,8). To the best of our knowledge stent migration into the appendix with perforation has not been reported previously.…”

“…The most common site of a perforation due to a stent is the duodenum (4)(5)(6). Sporadic cases of small-or large-bowel perforation have been reported (7,8). Interestingly, such perforations have occurred in conjunction with a separate predisposing factor such as diverticula, adhesions, or incarcerated bowel in an incisional hernia (7,8).…”

Small bowel perforation from a migrated biliary stent: A case report and review of literature

“…Well described complications of biliary stent placement include stent occlusion by clogging with possible subsequent cholecystitis or cholangitis, pancreatitis from duct manipulation, hemorrhage, stent fracture and stent migration[ 1 , 2 , 6 , 7 ]. The total rate of biliary stent complications varies among different institutes because of different level of experience, different available equipment and different etiologic reasons for the intervention.…”

“…According to Arhan et al [ 2 ] the complication rete for biliary stents is between 8% and 10%. Stent migration rate ranges from 5% to 10%, with the migration rates in plastic stents higher compared to others[ 2 , 7 , 8 ]. Biliary stent migration can be further categorized into proximal and distal migration.…”

Duodenal Perforation Secondary to Migrated Biliary Stent: A Rare and Serious Complication of Endoscopic Retrograde Cholangiopancreatography

“…We have observed that most reported cases of luminal perforation with biliary stents have been associated with a straight biliary stent. [6][7][8][9][10] From the available literature, we suggest that double pigtail stents are to be used to prevent such disastrous complication. Pigtail stents are less likely to migrate distally.…”