Aortoduodenal fistula and aortic aneurysm secondary to biliary stent-induced retroperitoneal perforation

Lee, Tae Hoon; Park, Do Hyun; Park, Jiyoung; Lee, Suck-Ho; Chung, Il‐Kwun; Kim, Hong Soo; Park, Sang‐Heum; Kim, Sun‐Joo

doi:10.3748/wjg.14.3095

Cited by 7 publications

(6 citation statements)

References 15 publications

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“…Intestinal perforations are usually caused by the sharp end of a metallic stent or stent migration. 1 - 3 Choledochoduodenal fistula caused by tumor invasion or spontaneous perforation of the bile duct have rarely been reported. 4 - 6 …”

Section: Discussionmentioning

confidence: 99%

Spontaneous Choledochoduodenal Fistula after Metallic Biliary Stent Placement in a Patient with Ampulla of Vater Carcinoma

Lee¹,

Park²,

Kim³

et al. 2009

Gut Liver

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Biliary stent-related enteric perforations are very rare complications that are caused by the sharp end of a metallic stent, stent migration, or tumor invasion. Moreover, the choledochoduodenal fistula resulting from metallic biliary stent-induced perforation is extremely rare. Here, we report a case in which a spontaneous choledochoduodenal fistula occurred after biliary metallic stent placement in a patient with an Ampulla of Vater carcinoma but was successfully managed by supportive treatments, including nasobiliary drainage. This case might have occurred as the result of a rupture of the bile duct following pressure necrosis and inflammation caused by impacted calculi and food materials over the tumor ingrowth in the uncovered biliary stent.

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Section: Discussionmentioning

confidence: 99%

Spontaneous Choledochoduodenal Fistula after Metallic Biliary Stent Placement in a Patient with Ampulla of Vater Carcinoma

Lee¹,

Park²,

Kim³

et al. 2009

Gut Liver

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“…was cured without any surgical intervention and he has been healthy without taking any antibiotics after 6 years since the spontaneous evacuation of the stent, contrary to the standard surgical removal process. Although one case of aortoduodenal fistula secondary to biliary stent placement has been reported, 3) the present case showing the spontaneous resolution of a graft-duodenal fistula which allowed the passage of a vascular stent has not yet been reported in the literature. The precise course of healing remains to be clarified, and the underlying reasons for the spontaneous resolution need further understanding.…”

Section: Introductionmentioning

confidence: 74%

Spontaneous Evacuation of a Vascular Metallic Stent through a Graft-Duodenal Fistula with Concomitant Non-Surgical Fistula Closure

Shindo

Inoue

Motohashi

et al. 2016

Annals of Vascular Diseases

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“…To the best of our knowledge, this is the first study to report on the actual prevalence rate of SMDP in a large consecutive cohort of patients that undergo ERC. Previous publications only comprise case reports 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 . Prevalence rates in our study may seem high, however, SMDP may well be an underreported complication, due to hesitation of physicians to report a complication that may be (falsely) attributed to inadequate technical skills.…”

Section: Discussionmentioning

confidence: 99%

“…These findings are in line with other reports 4 5 8 13 17 23 24 25 27 28 29 . Only two case reports were published in which a perforation was reported with shorter stents 9 10 11 12 13 14 15 . Longer stent length was also associated with a higher risk of SMDP at univariate regression analysis.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of and risk factors for stent migration-induced duodenal perforation

et al. 2021

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Background and study aims The safety of transpapillary biliary drainage by stent placement through endoscopic retrograde cholangiography (ERC) may be compromised by the occurrence of stent migration-induced perforation of the duodenal wall (SMDP). We aimed to assess the prevalence rate, risk factors and clinical course of SMDP. Patients and methods This retrospective cohort study included all patients who underwent an ERC with biliary plastic stent placement, between January 2014 and December 2018. Patients with an SMDP were identified from our endoscopy complication registry. Results 1227 patients underwent an ERC, of whom 629 patients (51 %) with biliary plastic stent placement; in 304 patients (25 %) stents were placed for perihilar strictures. Thirteen patients with SMDP were identified. The prevalence was 2.1 % for patients with biliary plastic stent placement and 4.3 % for patients stented for a perihilar stricture. All SMDPs occurred in patients with a perihilar stricture and with stents ≥ 12 cm (range 12–20 cm). Another potential risk factor was stent insertion into the left liver lobe, which was present in 10 of 13 patients. In 10 of 13 patients, SMDP was clinically suspected. Three of 13 patients were asymptomatic and diagnosed at elective stent retrieval. Eight patients could be endoscopically treated with an over-the-scope clip. Four patients died due to abdominal sepsis despite repeated interventions. Conclusion SMDP is a rare but potentially life-threatening complication of ERC after transpapillary drainage for perihilar biliary strictures. Stents ≥ 12 cm and stent insertion into the left liver lobe may be associated risk factors.

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Aortoduodenal fistula and aortic aneurysm secondary to biliary stent-induced retroperitoneal perforation

Cited by 7 publications

References 15 publications

Spontaneous Choledochoduodenal Fistula after Metallic Biliary Stent Placement in a Patient with Ampulla of Vater Carcinoma

Spontaneous Choledochoduodenal Fistula after Metallic Biliary Stent Placement in a Patient with Ampulla of Vater Carcinoma

Spontaneous Evacuation of a Vascular Metallic Stent through a Graft-Duodenal Fistula with Concomitant Non-Surgical Fistula Closure

Prevalence of and risk factors for stent migration-induced duodenal perforation

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