Duodenal-colic fistula resulting from migration of a biliary stent: a case report

Migration of biliary plastic stents: experience of a tertiary center

“…Two previous studies have reported the complication frequency to be 43% and 19%, respectively [21,24]. Rare complications of biliary stents migration have also been reported, such as intestinal obstruction and perforations, acute appendicitis, fistula between gastrointestinal tract and other organs, biliary pneumonitis, and hepatic perforation [39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54]. None of the patients with migration had such a complication in the present study.…”

Implantation of migrated biliary stents in the digestive tract

“…Fixation of bowel to a hernial sac, previous postoperative eventration or adherence is the common denominator for wall perforation because these conditions impede progression [5, 21]. Ang and Wanshik [22] described a duodenocolic fistula caused by a stent.…”

Silent duodenocolic fistula secondary to biliary stent migration

“…Iatrogenic causes are even rarer, and mostly related to operative injury to the duodenum or colon 2,5 . In the era of endoscopic surgery, biliary stent migration is another rare iatrogenic cause of duodenocolic fistula 6,7 …”

“…Perforation of both duodenum and colon by a migrating biliary stent with resultant internal fistulation is extremely rare and may present with biliary sepsis secondary to colonization of the stent and biliary tree by colonic flora 6 or remain silent 7 . As in our patient, the stents that were used in these reported cases were also a straight‐type, 10 Fr biliary stent 6,7 . The likely mechanism of such fistula formation was the erosion through the duodenum and colon with subsequent fistulation by the distally migrated biliary stent.…”

“…Surgical resection of the fistula together with the associated pathology is the most definitive treatment 1–5 . For stent‐related duodenocolic fistula, removal of the stent is most important which can be achieved surgically 6 or endoscopically 7 with or without resection of the fistula tract. We attempted to push the biliary stent back into the duodenum but failed because of the tight proximal malignant stricture.…”